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The Evolving Concept of Damage Control in Neurotrauma: Application of Military Protocols in Civilian Settings with Limited Resources
- Source :
- World neurosurgery. 125
- Publication Year :
- 2018
-
Abstract
- Objective The aim of the present review was to describe the evolution of the damage control concept in neurotrauma, including the surgical technique and medical postoperative care, from the lessons learned from civilian and military neurosurgeons who have applied the concept regularly in practice at military hospitals and civilian institutions in areas with limited resources. Methods The present narrative review was based on the experience of a group of neurosurgeons who participated in the development of the concept from their practice working in military theaters and low-resources settings with an important burden of blunt and penetrating cranial neurotrauma. Results Damage control surgery in neurotrauma has been described as a sequential therapeutic strategy that supports physiological restoration before anatomical repair in patients with critical injuries. The application of the concept has evolved since the early definitions in 1998. Current strategies have been supported by military neurosurgery experience, and the concept has been applied in civilian settings with limited resources. Conclusion Damage control in neurotrauma is a therapeutic option for severe traumatic brain injury management in austere environments. To apply the concept while using an appropriate approach, lessons must be learned from experienced neurosurgeons who use this technique regularly.
- Subjects :
- Damage control
Adult
medicine.medical_specialty
education
Medically Underserved Area
Wounds, Penetrating
Wounds, Nonpenetrating
Neurosurgical Procedures
Patient Positioning
Surgical Flaps
03 medical and health sciences
0302 clinical medicine
Clinical Protocols
Brain Injuries, Traumatic
Medicine
Humans
In patient
Emergency Treatment
Therapeutic strategy
Intraoperative Care
business.industry
Wound Closure Techniques
Middle Aged
medicine.disease
Military Health
Damage control surgery
030220 oncology & carcinogenesis
Surgery
Narrative review
Neurology (clinical)
Medical emergency
Neurosurgery
business
Tomography, X-Ray Computed
Limited resources
Organ Sparing Treatments
030217 neurology & neurosurgery
Craniotomy
Forecasting
Subjects
Details
- ISSN :
- 18788769
- Volume :
- 125
- Database :
- OpenAIRE
- Journal :
- World neurosurgery
- Accession number :
- edsair.doi.dedup.....e1a6962d2dd38a04c52e94a7cf74c58a