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• W2035239042 abstract "The principles for damage control were first described for the management of patients with the devastating penetrating injury to the abdomen. The same principles can be applied to injury to the pelvis and the extremities. In this article we extrapolate from the basic principles of this surgical technique and present a clinically relevant discussion of damage control in the pelvis and extremity. Although techniques for damage control continue to evolve, virtually no literature specifically addresses pelvic and extremity trauma. Thus, we are not able to present a cookbook approach to the problem. Instead, this article focuses on some general principles of care and then discusses devastating pelvic injury secondary to both blunt and penetrating trauma. We describe the current approach to the mangled extremity and discuss indications for primary amputation. The nature of pelvic and extremity injuries necessitates a multispecialty team effort in the care of these patients because fractures are usually associated with massive soft-tissue and vascular injuries. This underscores the critical role that orthopedic and plastic surgeons must play in the management of these patients. The anatomy of the pelvis makes surgical hemostasis difficult if not impossible in many cases. An expert and readily available intervention radiology service is often life-saving in these patients. However, the trauma surgeon must continue to play the leading role within this multispecialty team and make management decisions based on the patient's physiology as well as the adequacy of resuscitation. Although many patients who sustain devastating injuries to the pelvis or to an extremity die or have substantial functional disabilities, it is our opinion that rapid assessment, resuscitation, and a multidisciplinary team approach give these patients the best chance at functional survival." @default.
• W2035239042 created "2016-06-24" @default.
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• W2035239042 date "1997-08-01" @default.
• W2035239042 modified "2023-10-18" @default.
• W2035239042 title "DAMAGE CONTROL FOR DEVASTATING PELVIC AND EXTREMITY INJURIES" @default.
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• W2035239042 doi "https://doi.org/10.1016/s0039-6109(05)70591-0" @default.
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