Damage Control Laparotomy in Trauma Patients: A Level I Trauma Center Experience
AJTES Vol 9, No 1, January 2025
Duncan A. J., et al. - Damage Control Laparotomy in Trauma Patients.

Keywords

Damage control surgery
Trauma
Mortality
Trauma Center

How to Cite

Duncan, A., Hopper, W., & Ahmeti, M. (2025). Damage Control Laparotomy in Trauma Patients: A Level I Trauma Center Experience. Albanian Journal of Trauma and Emergency Surgery, 9(1), 1599-1605. https://doi.org/10.32391/ajtes.v9i1.423

Abstract

Introduction: The surgical management of traumatic injury is an evolving and controversial topic. We present outcomes of laparotomy performed for blunt and penetrating trauma at a level I trauma center over a nearly 10-year period.

Material and Methods: Retrospective single-center cohort study of patients who received either damage control laparotomy or definitive laparotomy with fascial closure at the time of index procedure. The primary outcome was in-hospital mortality. Secondary outcomes were length of stay, complications, intensive care requirements, and vasopressor use.

Results: Out of 125 included patients, 69 received damage control laparotomy, and 56 received definitive laparotomy.  Damage control laparotomy was associated with significantly higher mortality (20.9% vs 1.8%, p=.0015) and length of stay (16.1 vs. 9.3 days, p=.0005) than definitive laparotomy. Complications occurred significantly more frequently among damage control laparotomy patients (53.6% vs. 14.3%, p<.0001). Damage control laparotomy patients were substantially more likely to require intensive care unit admission, mechanical ventilation, and vasopressor support.

Conclusion: Patients undergoing damage control laparotomy are at significantly increased risk for adverse outcomes, including increased in-hospital mortality, prolonged length of stay, more significant complication burden, and increased need for mechanical ventilation and pressure support as compared to patients undergoing definitive laparotomy.

https://doi.org/10.32391/ajtes.v9i1.423
Duncan A. J., et al. - Damage Control Laparotomy in Trauma Patients.

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