Damage Control in Vascular Trauma

被引：0

作者：

Sellers, Michael Keith ^{[1
]}

Johnston, Luke R. ^{[2
]}

Atwood, Rex ^{[3
]}

Parker, William J. ^{[2
]}

Bozzay, Joseph D. ^{[1
,4
]}

Haurani, Mounir J. ^{[4
]}

Walker, Patrick ^{[1
]}

Bradley, Matthew J. ^{[1
]}

机构：

[1] Uniformed Serv Univ Hlth Sci, Dept Surg, Bethesda, MD 20814 USA

[2] Naval Med Ctr Camp Lejeune, Dept Gen Surg, Camp Lejeune, NC USA

[3] Naval Med Ctr Portsmouth, Dept Gen Surg, Norfolk, VA USA

[4] Ohio State Univ, Wexner Med Ctr, Dept Surg, Div Vasc Dis & Surg, Columbus, OH USA

来源：

CURRENT TRAUMA REPORTS | 2024年

关键词：

Vascular Injury; Damage Control; Military Surgery; Prehospital; Shunt; Resuscitation; ENDOVASCULAR BALLOON OCCLUSION; LOWER-LIMB SALVAGE; CONTROL RESUSCITATION; TRANEXAMIC ACID; TOURNIQUET USE; COMPARTMENT SYNDROME; HEMORRHAGE CONTROL; IMPROVED SURVIVAL; ARTERIAL SHUNTS; BLOOD-PRODUCTS;

D O I：

10.1007/s40719-024-00271-1

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose of ReviewDamage control management of vascular trauma involves stopping the hemorrhage and facilitating resuscitation. This review seeks to inform providers on the advances of prehospital care, improved understanding of resuscitation, and increasingly complex decision-making regarding definitive repair.Recent FindingsRecent emphasis on tourniquets has improved extremity hemorrhage control. Advances in hemostatic agents and junctional tourniquets are being explored for traditionally "non-compressible" hemorrhage. Resuscitative endovascular balloon occlusion of the aorta (REBOA) remains controversial. Whole blood or 1:1:1 blood-product-ratio resuscitation can correct physiology, preserving life and limb. Surgical options include primary repair or interposition grafting, shunting, or ligation. Shunting and proper fasciotomy remain useful tools for damage control and limb salvage.SummaryDamage control in vascular trauma remains a life-saving and limb-saving strategy. Modern prehospital treatment may increase the number of patients who arrive alive to the trauma bay. Appropriate surgical judgement and perioperative principles remain the cornerstones of individualized management in the modern era.

引用

页数：11

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