Damage Contol Orthopaedics

  • Involves staging and defininitive management to avoid adding trauma to patient during vulnerable period.
    • The decision to operate and surgical timing on multiple injured trauma patients remains controversial
    • Intra-operative hypotension increases mortality rate in patients with head injury
  • Parameters that help decide who should be treated with DCO    
    • ISS >40 (without thoracic trauma)
    • ISS >20 with thoracic trauma
    • Multiple injuries with severe pelvic/abdominal trauma and hemorrhagic shock
    • Bilateral femoral fractures
    • Pulmonary contusion noted on radiographs
    • Hypothermia <35 degrees C
    • Head injury with AIS of 3 or greater
  • Optimal time of surgery    
    • Patients are at increased risk of ARDS and multisystem failure during acute inflammatory window (period from 2 to 5 days characterized by a surge in inflammatory markers)
      • Therefore only potentially life-threatening injuries should be treated in this period including :
        • compartment syndrome
        • fractures with vascular injuries
        • unreduced dislocations
        • long bone fractures
        • unstable spine fractures
        • open fractures

About Dr. Tushar Mehta

MBBS , DNB (Ortho), MNAMS, PGDCR, http://www.facebook.com/orthopaedicsplus.in

One Thought on “Damage Contol Orthopaedics

  1. sir i am really a fan of ur teaching. i m amazed how u make every thing so simple and interesting. u r like a god of orthopaedics. all teachers should be like u.

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