Effectiveness of damage control surgery versus conventional surgery in patients with severe abdominal trauma in Abel Gilbert Pontón specialty hospital

Abstract

Introduction Damage control surgery has constituted an orderly step strategy that allows a severely traumatized patient to be given a second chance, with the purpose of preventing the deadly triad (coagulopathy, acidosis, hypothermia), in this paper the surgery is compared Conventional with damage control surgery Objective: To analyze the effectiveness of damage control surgery (CCD) versus conventional surgery (CC) in patients with severe abdominal trauma. Methodology: Patients with severe abdominal trauma undergoing damage control surgery and conventional surgery were included in the Surgery Service of the Abel Gilbert Pontón Hospital from January 2016 to December 2018. For which data from the computer system, medical records were reviewed. and operating records. Results: Of the studied population represented by fifty-eight patients, 79% underwent damage control surgery and 21% conventional surgery, with severe hemodynamic alterations assessed by ISS scales, RTS, Shock index. The most frequent type of trauma in the CCD was the penetrating in 59%, while in the CC the closed trauma represented by 58% was more frequent. Within the study it was observed that there was an alteration of coagulopathy in a greater percentage in patients undergoing damage control surgery with 61%. In both groups the most frequent surgical time is given between the ranges of 61 to 120 min. And the days of stay in the ICU were greater than 7 days with a totalization in their hospitalization days were greater than 15 days for both surgical strategies. Of the group studied, the one with the lowest mortality was in CCD with 33%, and the one with the highest mortality was in patients with mixed lesions 60% in CCD and in a minority 36% in CC. According to the RTS scale, there was a better survival in patients with CCD with 72%, it was also established in the mortality adjusted to the ISS that there are better results in the CCD since increasing their index does not increase their mortality. Conclusions: Damage Control surgery has a better outcome in the scenario of patients with severe penetrating abdominal trauma. Keywords: damage control, abdominal trauma, conventional surgery.