Thoracic damage control

Abstract

The successful management of patients sustaining severe or life-threatening thoracic injuries demands a rapid and organized approach to injury identification and operative intervention based on the principles of damage control surgery. Resuscitative thoracotomy remains the procedure of choice for patients who present in extremis or agonal following both blunt and penetrating truncal trauma. A variety of rapid and effective techniques for hemorrhage control and injury management are available to the trauma surgeon and should be used judiciously in the setting of exsanguination or life-threatening injuries to allow for the rapid transport of patients to the operating room for further temporary or definitive repair of injuries. In this chapter, we shall briefly review the key tenets and principles of damage control surgery as they relate to specific thoracic injuries.