Clinical profile and outcome of damage control laparotomies in a tertiary care centre

Abstract

Trauma is the major cause of death worldwide. Survival of the major trauma victims can be improved by the principles of damage control surgery. The vicious cycle of trauma triad, namely, hypothermia, coagulopathy and acidosis should be intercepted by the quick abbreviated laparotomy and subsequently physiological imbalance is corrected by secondary resuscitation in the surgical intensive care unit. Definite repair can be taken later on. Abdominal compartment syndrome is the most formidable complication. Multidisciplinary team approach is needed to alleviate the physical and psychological trauma of the patient. Objective: To study the clinical profile and outcomes of the patients undergoing damage control laparotomy and to determine the factors responsible of the morbidity and mortality. Also to compare the characteristics of patients undergoing damage control surgery for traumatic as well as non-traumatic patients. The study was conducted in Department of General Surgery, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun after approval of institute ethic committee over a period of 18 months. All the patients who underwent damage control for traumatic as well as non-traumatic cases were included in the study. Based on the records from the previous year, 30 patients were recruited for convenient sampling method. Clinical profile and outcome of 25 traumatic patients and 6 non-traumatic cases were compared. Prothrombin Time and International Normalized Ratio (PT/INR), injury site to Emergency room time and Injury site to operating room time were found to be confounding factors which had a role in predicting mortality.

Keywords

• Damage control surgery
• trauma triad
• hypothermia
• coagulopathy
• acidosis
• abdominal com
• abdominal compartment syndrome