In damage control surgery for abdominal trauma, the sequence of operations is correctly described as:
- A Abbreviated surgery for haemorrhage/contamination control, ICU resuscitation, then definitive repair at 24–72 hours ✓
- B Definitive repair, followed by ICU stabilization, then planned re-laparotomy if needed
- C Percutaneous angioembolization first, then laparotomy if embolization fails
- D FAST-guided immediate damage control resuscitation without surgery for 24 hours
Correct answer: A. Abbreviated surgery for haemorrhage/contamination control, ICU resuscitation, then definitive repair at 24–72 hours
Explanation
Damage control surgery follows a three-phase approach: Phase 1 — abbreviated laparotomy for life-threatening haemorrhage control (packing, temporary vascular shunts) and contamination control (stapling bowel ends without anastomosis); Phase 2 — ICU correction of the 'lethal triad' (hypothermia, coagulopathy, acidosis), typically 24–72 hours; Phase 3 — planned return to theatre for definitive repair, bowel anastomosis, and closure. This approach improves survival in the most physiologically compromised trauma patients.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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