DAMAGE CONTROL SURGERY IN PATIENTS WITH HEPATIC TRAUMA: A LITERATURE REVIEW

Abstract

Severe liver injuries present high morbidity and mortality rates in trauma patients. Among the treatment advances for liver trauma, damage control surgery (DCS) is a relevant approach for managing traumatized individuals with physiological exhaustion and multiple injuries. DCS prioritizes hemorrhage control in severely affected patients affected by the deadly triad: metabolic acidosis, hypothermia, and coagulopathy. DCS is an approach designed for patients with complex injuries, focusing on hemorrhage control, contamination prevention, and patient stabilization, aiming to restore physiological parameters before definitive treatment. The choice of DCS requires careful evaluation and is indicated for unstable patients with significant physiological compromise, where survival with definitive surgery is unlikely, with the goal of interrupting the deadly triad. Complex liver injuries are still associated with high morbidity and mortality rates, so the decision to interrupt laparotomy and initiate tamponade with compresses should be made early and cautiously. Although DCS is a valuable tool, further research is needed to establish clear indication criteria. DCS remains important for the treatment of severe injuries, providing a vital chance of survival for critical patients.