Commonly described stages of civilian damage control surgery
| Stage | Description |
|---|---|
| DC0* | Initiation of damage control resuscitation and selection of patients appropriate for a damage control versus single-stage surgical procedure (the focus of this proposal) |
| DC1 | Abbreviated surgical operation: Interventions utilised may include perihepatic packing of liver and juxtahepatic venous injuries, wide drainage (with closed suction drains) and gauze packing of pancreatic head injuries (as opposed to attempts at pancreaticoduodenectomy or Whipple's procedure), resection of major gastrointestinal tract injuries without reanastomosis, pulmonary tractotomy, non-anatomic resection of peripheral lung injuries, use of temporary intravascular shunts to bridge injured vascular structures, and insertion of balloon occlusion catheters into bleeding wound tracts. This stage typically ends with temporary abdominal, thoracic, or other closure using one of many different techniques |
| DC2 | Resuscitation in the ICU: This frequently includes vigorous rewarming of hypothermic patients, fluid and blood resuscitation, correction of coagulopathy and acidaemia and support of injured lungs and failing or failed kidneys |
| DC3 | Reoperation with attempted completion of definitive surgical repairs and formal closure of the abdomen, chest or other bodily region, where possible: This stage often also includes a search for missed intracavitary injuries as well as creation of ostomies, and may include placement of surgical feeding tubes |
| DC4 | Reconstructive surgery: This includes definitive fascia-to-fascia closure of the abdominal wall in a patient initially managed with a planned ventral hernia (ie, split-thickness skin graft placed directly atop granulating viscera of the patient's open abdomen) |
*Frequently also referred to as ‘damage control ground 0’.
ICU, intensive care unit.