The damage control laparotomy.

The damage control laparotomy is an advancement in the management of massively injured trauma victims. Mortality for this group of patients remains high but some can be saved using staged abdominal reconstruction for trauma. Massive liver injuries, pelvic trauma, and retroperitoneal injury are some of the indications for this approach. Careful replacement of blood and blood products along with correction of hypothermia and optimization of oxygen transport represents a critical phase in this management approach. It must be emphasized that abdominal packing must not be used without repairing major vascular injuries. Premature packing and inadequate packing also should be avoided. This staged approach to abdominal trauma is not a panacea; however, improved trauma care is possible if this technique is used carefully.