Damage Control concept. Historical evolution and break of the concept

Historical evolution of Damage Control surgery shows that it emerged in years 80 of the last century to treat patients arriving with multiple abdominal penetrations caused by automatic weapons and for which the traditional approach was not effective. A combination of acidosis, hypothermia and coagulopathy, known as the « lethal triad », was commonly seen in these patients and often precluded the completion of the operation. Damage Control surgery initially refers to the temporary maneuvers designed to ensure patient survival. Once hemodynamic stability was restored and the coagulopathy corrected, definitive surgical repairs were later completed.Nowadays, Damage Control is considered as a true strategy including all stages of the treatment: initial resuscitation – surgery on emergency – post operative reanimation – secondary surgery. The concept of Damage Control has been extended to vital lesions of other parts of the body and to non-vital lesions which yet require a sequential strategy as the open fractures stage Gustilo 3C.