The Evolving Concept of Damage Control in Neurotrauma: Application of Military Protocols in Civilian Settings With Limited Resources.
Citation: World Neurosurgery. 125:e82-e93, 2019 05.PMID: 30659971Institution: MedStar Washington Hospital CenterDepartment: RadiologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Brain Injuries, Traumatic/su [Surgery] | *Neurosurgical Procedures/mt [Methods] | *Wounds, Nonpenetrating/su [Surgery] | *Wounds, Penetrating/su [Surgery] | Adult | Clinical Protocols | Craniotomy/mt [Methods] | Emergency Treatment/mt [Methods] | Forecasting | Humans | Intraoperative Care | Medically Underserved Area | Middle Aged | Military Health | Organ Sparing Treatments/mt [Methods] | Patient Positioning | Surgical Flaps | Tomography, X-Ray Computed | Wound Closure TechniquesYear: 2019ISSN:- 1878-8750
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Journal Article | MedStar Authors Catalog | Article | 30659971 | Available | 30659971 |
Copyright (c) 2019. Published by Elsevier Inc.
Damage control surgery has been described as a sequential therapeutic strategy that supports physiological restoration over anatomical repair in patients with critical injuries. The application of this concept in neurosurgery has evolved since early definitions in 1998. Current strategies have been supported by military neurosurgery experience and the concept is being applied in civilian settings with limited resources. The aim of this narrative review is to describe the evolution of the concept, the surgical techniques and the lessons learned from civilian and military neurosurgeons who apply the concept regularly, especially in practice at military hospitals or in civilian institutions with limited resources in low and middle income countries. Damage control in neurotrauma is a therapeutic option for severe traumatic brain injury management in austere environments. In order to apply the concept of damage control in neurotrauma while using an appropriate approach, lessons must be learned from experienced neurosurgeons who use this technique regularly.
English