Damage control surgery (DCS) in a multiply-injured trauma patient follows a three-phase approach. The correct sequence of phases is:

• A ICU resuscitation → abbreviated laparotomy → definitive surgery
• B Definitive surgery → ICU → re-look laparotomy
• C Total body CT → ICU resuscitation → DCS laparotomy
• D Abbreviated laparotomy (haemostasis + contamination control) → ICU resuscitation → definitive surgery ✓

Explanation

Damage control surgery follows three sequential phases: Phase 1 — abbreviated laparotomy to achieve immediate haemostasis (packing, vessel ligation), contamination control (bowel stapling), and abdominal closure (temporary, e.g., bogota bag); Phase 2 — ICU resuscitation targeting correction of the 'lethal triad' (hypothermia, acidosis, coagulopathy); Phase 3 — return to theatre for definitive repair (anastomosis, reconstruction) after physiological stabilisation. CT scanning precedes DCS decision-making but is not part of the DCS phases themselves.

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

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