Damage Control Resuscitation in Traumatic Hemorrhage: It is More Than Fixing the Holes and Filling the Tank

Trauma remains the leading cause of death and disability in individuals younger than 44 yr of age, and hemorrhage is the most common cause of preventable death after a traumatic mechanism of injury. Each year nearly 1.5 million deaths worldwide are the result of trauma-related hemorrhage.¹  During the past 20 yr there has been significant improvement in the management and resuscitation of hemorrhagic shock, attributed in large part to experiences from military conflict. First described in the early 1990s, damage control laparotomy reflected such a concept and was directed toward the timing and method of operative intervention for abdominal trauma to limit prolonged operations that occurred with definitive repair, further unnecessary blood loss, and exposure of an open abdomen to continued loss of heat and subsequent hypothermia.^2,3  Evolution of endovascular therapy for certain organ system injuries, such as splenic, hepatic, and renal trauma, has continued to...