A trauma patient with a penetrating abdominal injury undergoes damage control laparotomy (DCL). The bowel ends are stapled, major vessels are controlled, packs are placed, and the abdomen is temporarily closed. Which physiological derangement does the 'lethal triad' of DCL primarily address?
- A Hypothermia, acidosis, and coagulopathy ✓
- B Hypoxia, hypercapnia, and hypovolaemia
- C Sepsis, organ failure, and ileus
- D Hyperglycemia, hyperkalemia, and metabolic alkalosis
Correct answer: A. Hypothermia, acidosis, and coagulopathy
Explanation
The lethal triad of trauma surgery consists of hypothermia, acidosis, and coagulopathy — a vicious cycle where each element exacerbates the others. Hypothermia impairs coagulation enzymes; acidosis worsens coagulopathy and myocardial function; coagulopathy leads to continued hemorrhage and worsening acidosis. Damage control surgery (pack → temporary closure → ICU resuscitation → planned re-look) interrupts this cycle by rapidly controlling hemorrhage and contamination, allowing resuscitation to correct the triad before definitive repair.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.