Die Damage-control-Strategie

Abstract

The concept of “damage control” (DC) is a treatment strategy for multiple trauma patients in order to reduce the impact of the initial surgical treatment. The DC concept is well accepted for the surgical control of abdominal bleeding. For the treatment of femoral fractures, primary definitive stabilization should be performed in stable multiple trauma patients. The DC concept seems to be the treatment of choice for patients with severe multiple trauma in an unstable condition and at high risk for developing systemic complications. For multiple trauma patients in an uncertain condition the timing of definitive surgical treatment of major fractures is still being controversially discussed. In these patients, the preoperative condition should be considered carefully when deciding on the type of initial fixation to perform. Anatomical, physiological as well as inflammatory parameters can be used to tailor the amount of surgery that is performed to the clinical condition of the patient.