What is damage control Orthopaedics?
Core tip: Damage control orthopaedics (DCO) is the treatment of lesions that provoke major bleeding and pathological inflammatory response, whilst avoiding the traumatic effects of major surgery in a patient who is already traumatised (the “second hit” effect).
What is damage control in medical terms?
DEFINITION: Damage control: Is an operative technique in which control of bleeding and stabilization of vital signs becomes the only priority in salvaging the patient. This usually occurs during laparotomy when there is significant bleeding in the abdomen.
What is second hit phenomenon?
The ‘second hit’ phenomenon is based on the fundamental concept that sequential insults, which are individually innocuous, can lead to overwhelming physiologic reactions. This response can be expressed in several organic systems and can be examined by measurement of several parameters.
What is Early Total Care?
2. Early Total Care (ETC) Early stabilization of major skeletal injuries was the mainstay of treatment in trauma surgery in the 80’s and early 90’s. ETC involves definitive surgical stabilization of all long-bone fractures during the early phase of treatment (24–48 h) [4.
What is damage control resuscitation?
DCS is a resuscitation strategy that was devised to avoid these physiological disorders. It consists of three steps: abbreviated surgery to control the hemorrhage and contamination, resuscitation in the intensive care unit (ICU), and planned re-operation with definitive surgery [20].
What is Bohler Braun splint?
Bohler Braun Splint. BOHLER BRAUN SPLINT (B.B. SPLINT) It is a common splint used in wards for immobilization and reduction of most lower limb fractures and treatment of other lower limb pathologies. Structure. It consists of an iron frame with a set of 4 pulleys for application of mobile traction.
What is damage control orthopaedics?
The concept of damage control orthopaedics (DCO)[1] originally concerned the provisional immobilisation of long bone fractures – mainly the femur – in the severely traumatised patient (STP) in order to minimise the traumatic effects of non-life saving surgical procedures, termed the “second hit” effect[2-5].
Is damage control orthopaedics right for borderline patients?
Damage control orthopaedics is ideal for an unstable patient or a patient in extremis, and it has some utility for the borderline patient as well.
What are the additional clinical criteria for shifting to damage control orthopaedics?
In Louisville, some of the additional clinical criteria that we have used as a basis for shifting to damage control orthopaedics include a pH of <7.24, a temperature of <35°C, operative times of more than ninety minutes, coagulopathy, and transfusion of more than ten units of packed red blood cells.
When did the era of damage control orthopaedics start?
The era of damage control orthopaedics started around 1993. Two reports from one institution 9, 10 described temporary external fixation of femoral shaft fractures in severely injured patients. From 1989 to 1990, the frequency of using temporary external fixation increased from <5% to >10%.