Damage control surgery–new concept or reenacting of a classical ideea?

Damage–control surgery is an example of a paradigm shift. The term is borrowed from naval terminology and means gaining the initial control of a damaged ship. Because of the lethal triad the polytrauma patient is at a grave risk. The classical concept of surgically solving all the patient's injuries in the first moment was even theoretically incorrect as a multiple injured patient is a critical patient with depleted reserves. As such, complex procedures were doomed from this point of view. The concept of damage–control surgery emerged in 1992. The core idea was that as minimal as possible had to be done in these critical patients in the first phase, meaning temporary control of a hemorrhage and simple measures for stopping contamination. After 24–48 hours in the ICU, in which time the physiological disturbances were corrected, a further intervention is performed for definitively treating the injuries. Further refinements consider five stages and not three in damage–control surgery. The bright side of the concept is an up to 70% survivability rate but with a higher risk of complications, mostly due to the policy of temporary closing the abdomen and sepsis.