ArticleTrauma surgery & acute care open2019
Damage control or definitive repair? A retrospective review of abdominal trauma at a major trauma center in South Africa.
Article in Trauma surgery & acute care open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Outcomes of damage control laparotomy after trauma in low andmiddle-income countries: A systematic review and meta-analysis.PloS one · 2026Pooled it
- A decade long overview of damage control laparotomy for abdominal gunshot wounds.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Proper hepatic artery transection followed by blunt abdominal trauma: A case report and review of literature.Clinical case reports · 2024Article
- Management of Hemorrhagic Shock: Physiology Approach, Timing and Strategies.Journal of clinical medicine · 2022Review
- A characterization of trauma laparotomies in a scandinavian setting: an observational study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Observational
- "Zooming" in strategies and outcomes for trauma cases with Injury Severity Score (ISS) ≥16: promise or passé?Revista da Associacao Medica Brasileira (1992) · 2022Article
- Damage control surgical management of combined small and large bowel injuries in penetrating trauma: Are ostomies still pertinent?Colombia medica (Cali, Colombia) · 2021Observational
- Damage Control Laparotomy: High-Volume Centers Display Similar Mortality Rates Despite Differences in Country Income Level.World journal of surgery · 2020Article
- Abbreviated Laparotomy in Emergency Colorectal Disease from Battlefield Innovations to Modern Practice.Journal of emergencies, trauma, and shockArticle
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study set out to review a large series of trauma laparotomies from a single center and to compare those requiring damage control surgery (DCS) with those who did not, and then to interrogate a number of anatomic and physiologic scoring systems to see which best predicted the need for DCS.
methodsAll patients over the age of 15 years undergoing a laparotomy for trauma during the period from December 2012 to December 2017 were retrieved from the Hybrid Electronic Medical Registry (HEMR) at the Pietermaritzburg Metropolitan Trauma Service (PMTS), South Africa. They were divided into two cohorts, namely the DCS and non-DCS cohort, based on what was recorded in the operative note. These groups were then compared in terms of demographics and spectrum of injury, as well as clinical outcome. The following scores were worked out for each patient: Penetrating Abdominal Trauma Index (PATI), Injury Severity Score, Abbreviated Injury Scale-abdomen, and Abbreviated Injury Scale-chest.
resultsA total of 562 patients were included, and 99 of these (18%) had a DCS procedure versus 463 (82%) non-DCS. The mechanism was penetrating trauma in 81% of cases (453 of 562). A large proportion of trauma victims were male (503 of 562, 90%), with a mean age of 29.5±10.8. An overall mortality rate of 32% was recorded for DCS versus 4% for non-DCS (p<0.001). In general patients requiring DCS had higher lactate, and were more acidotic, hypotensive, tachycardic, and tachypneic, with a lower base excess and lower bicarbonate, than patients not requiring DCS. The most significant organ injuries associated with DCS were liver and intra-abdominal vascular injury. The only organ injury consistently predictive across all models of the need for DCS was liver injury. Regression analysis showed that only the PATI score is significantly predictive of the need for DCS (p=0.044). A final multiple logistic regression model demonstrated a pH <7.2 to be the most predictive (p=0.001) of the need for DCS.
conclusionDCS is indicated in a subset of severely injured trauma patients. A pH <7.2 is the best indicator of the need for DCS. Anatomic injuries in themselves are not predictive of the need for DCS. LEVELS OF EVIDENCE: Level III.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.