Early management of complication on severe multiple trauma

Abstract

Objective To analyze the efficacy of early management of complications in patients with multiple traumas by applying the damage control theory. Method All total of 116 patients admitted to Wuhan Tongji Hospital between Jan 2006 and Jan 2008 were included in this retrospective study and were classified according to treatment method. Overall, 55 cases underwent damage control operations and 61 cases underwent conventional management. The groups of patients were compared in terms of parameters such as length of operation time, time to trsuscitate from shock, lethal triad of death （LTD）, complications and treatment outcomes after operation. Results The length of operation time was （67.43 ± 19.52） min, resuscitation time from shock was （6.77 ± 3.16） h and LTD was （11.54±4.10） h in the damage control group, and （163.95±55.41） min, （22.51 ± 11.65） h and （34.55± 5.63） h, respectively, in the conventional group, with significant differences between the two groups （ P 〈 0.01 ）. The per capita complication and mortality rates were 227.27 % and 3.64 %, respectively, in the damage control group and 363.93% and 9.84%, respectively, in the conventional group （P 〈 0.05）. Conclusions Here, we demonstrated that early management of patients with multiple traumas undergoing operations by applying the damage control theory significantly decreased the operation time, and decreased time to resuscitation from shock and LTD. Furthermore, this approach significantly reduced the incidence of complications and the mortality rate of patients with severe multiple traumas. Key words: Multiple trauma; Damage control; Shock; Lethal triad of death; Complication