Current opinion in critical care · 2012
Damage control orthopedics: current evidence.
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Lichte Philipp, Kobbe Philipp, Dombroski Derek, Pape Hans C
Аннотация
PURPOSE OF REVIEW: There is still an ongoing debate whether damage control orthopedics (DCO) or other treatment strategies should be favored in the treatment of multiply injured patients. This review gives an overview of the current literature concerning this important question in the treatment of severely injured patients.
RECENT FINDINGS: Several studies could show that DCO can reduce the inflammatory burden due to surgery (second hit). The only randomized study showed a benefit for borderline patients treated by DCO in comparison to early total care. Other studies showed advantages for early care treatment in similar patients.
SUMMARY: In severely injured patients, DCO should be considered. On the other hand, there is still a lack of randomized studies for a more precise characterization of the patients who benefit from DCO treatment.
RECENT FINDINGS: Several studies could show that DCO can reduce the inflammatory burden due to surgery (second hit). The only randomized study showed a benefit for borderline patients treated by DCO in comparison to early total care. Other studies showed advantages for early care treatment in similar patients.
SUMMARY: In severely injured patients, DCO should be considered. On the other hand, there is still a lack of randomized studies for a more precise characterization of the patients who benefit from DCO treatment.