损伤控制手术后再干预。

Pub Date : 2021-06-30 eCollection Date: 2021-04-01 DOI:10.25100/cm.v52i2.4805
David Mejia, Salin Pereira Warr, Carlos Andrés Delgado-López, Alexander Salcedo, Fernando Rodríguez-Holguín, José Julián Serna, Yaset Caicedo, Luis Fernando Pino, Adolfo González-Hadad, Mario Alain Herrera, Michael W Parra, Alberto García, Carlos A Ordoñez
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引用次数: 0

摘要

损害控制有明确的步骤。然而,关于谁、何时以及如何进行再干预仍然存在争议。本文总结了加州-哥伦比亚创伤与急诊外科小组(CTE)关于对接受损伤控制手术的患者进行二次干预的具体情况的建议。我们建议将包装作为首选的出血控制策略,然后在接下来的48-72小时内拆包。此外,建议延期吻合矫正肠道病变,血管分流治疗的患者应在24小时内再次介入,以确定治疗。此外,腹壁或胸壁应在8天内关闭。这些策略旨在减少并发症、发病率和死亡率。
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Reinterventions after damage control surgery.

Damage control has well-defined steps. However, there are still controversies regarding whom, when, and how re-interventions should be performed. This article summarizes the Trauma and Emergency Surgery Group (CTE) Cali-Colombia recommendations about the specific situations concerning second interventions of patients undergoing damage control surgery. We suggest packing as the preferred bleeding control strategy, followed by unpacking within the next 48-72 hours. In addition, a deferred anastomosis is recommended for correction of intestinal lesions, and patients treated with vascular shunts should be re-intervened within 24 hours for definitive management. Furthermore, abdominal or thoracic wall closure should be attempted within eight days. These strategies aim to decrease complications, morbidity, and mortality.

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