Objective To explore the appl ication of damage control surgery (DCS) strategy in the treatment of severe burn-trauma combined injury. Methods From January 2004 to December 2009, 28 patients with severe burn-trauma combined injury received salvage treatment according to DCS, including 12 cases of burn combining injury at 2 sites, 6 cases ofburn combining injury at 3 sites, and 10 cases of burn combining injury at 4 sites or above. There were 18 males and 10 females with a median age of 39.5 years (range, 8-56 years). The burn area was 15% to 56% of total body surface area. The injury severity score a (ISS) was 25 to 56, and the traumatic index was 17 to 24. Lethal triad syndrome occurred in all patients. Of them, 16 cases were on admission immediatly after first-aid, and 12 cases were thansferred from other hospitals. The time from injury to hospital ization was 20 minutes to 36 hours. All patients were treated by immediate fluid resuscitation and emergent operation to control hemorrhage and contaminations. Biological dressings were used to seal the wounds provisionally. The systemic therapy was carried out as soon as the vital signs of the patients became stable. Results In 26 survivors, 23 achieved wound heal ing by first intention, 3 had a l ittle residual wound at discharge. The hospital ization days were 31 to 398 days (62 days on average). However, 1 patient died of multiple organ failure, another 1 patient died of severe cerebral trauma with refractory shock. Conclusion The DCS strategy is effective in reducing mortal ity of patients with severe burn-trauma combined injury.
ObjectiveTo explore the application value of damage control in intra-abdominal sepsis. MethodsThe related literatures were searched by searching literatures with " damage control” " damage control resuscitation” damage control surgery”, and " intra-abdominal sepsis”, to made an review. Results Despite significant advances in management and treatment, mortality from intra-abdominal sepsis remained still high. Due to its unique anatomic and microbial environment, initial operation could not completely remove the source of infection and avoid complications. Therefore, it was becoming increasingly popular to utilize a damage control strategy with abbreviated laparotomy and planned reoperations. ConclusionsDamage control is characterized by staged treatment, and is widely accepted used to manage intra-abdominal sepsis.