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damage control surgery
Damage control surgery (DCS) is a technique of surgery utilized to care for critically ill patients. While typically trauma surgeons are heavily involved in treating such patients, the concept has evolved to other sub-specialty services. The leading cause of death among trauma patients remains uncontrolled hemorrhage and accounts for approximately 30–40% of trauma related deaths.〔Duschene, 2010〕 This technique places emphasis on preventing the "lethal triad", rather than correcting the anatomy. Damage control surgery is meant to be utilized as a measure that saves lives. A multi-disciplinary group of individuals is required: nurses, respiratory therapist, surgical-medicine intensivists, blood bank personnel and others. While this lifesaving method has resulted in a significant decrease in the morbidity and mortality of critically ill patients, complications can result and do exist. This procedure is generally indicated when a person sustains a severe injury that impairs the ability to maintain homeostasis due to severe hemorrhage leading to metabolic acidosis, hypothermia, and increased coagulopathy. The approach would provide a limited surgical intervention in order to control both hemorrhage and contamination. This will subsequently allow for clinicians to focus on reversing the physiologic insult prior to completing a definitive repair. While the temptation to perform a definitive operation exists, surgeons should avoid this practice because of the deleterious effects on patients can result them succumbing to the physiologic effects of the injury, despite the anatomical correction.
==Technique==
Damage control surgery can be divided into the following three phases: Initial laparotomy, Intensive Care Unit (ICU) resuscitation, and definitive reconstruction. Each of these phases has defined timing and objectives to ensure best outcomes. The following goes through the different phases in order to illustrate step by step how one might approach this. There are clearly different approaches throughout the country, and no one way is necessarily correct. However, the ability to evaluate objectively the differences and then choose the one that fits your team is important.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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