Damage control surgery (DCS) for abdominal trauma involves an abbreviated initial operation followed by ICU resuscitation and planned re-look laparotomy. The physiological triad of lethal causes indicating DCS should be used ('lethal triad') consists of:

• A Hypovolaemia, hyperglycaemia, and dilutional anaemia
• B Hypothermia, acidosis, and coagulopathy ✓
• C Respiratory failure, renal failure, and hepatic dysfunction
• D Tachycardia, hypotension, and coagulopathy

Explanation

The 'lethal triad' (or 'triad of death') in major trauma comprises hypothermia (core temperature <35°C), metabolic acidosis (base deficit <−6 or pH <7.25), and coagulopathy (INR >1.5, APTT >60 s). Each element amplifies the others: hypothermia impairs clotting enzyme kinetics, acidosis further impairs coagulation, and both worsen bleeding. Recognising the lethal triad triggers damage control resuscitation (balanced blood products, TXA, permissive hypotension) and damage control surgery to address surgical bleeding before full resuscitation.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.