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    Damage Control Orthopedic - ASW

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    Aisyah Khumairah
    The document discusses pathophysiology and damage control orthopaedics (DCO) in trauma patients. It notes that there are three peak times of death after trauma: within minutes due to blood loss or neurologic injury, within days due to shock/hypoxia/neurologic injury, and within weeks due to multi-system organ failure or infection. DCO aims to control hemorrhage, remove dead tissue to prevent further injury, and relieve pain to facilitate intensive care, rather than immediately fixing all fractures which could be harmful for multiply injured patients. The goals of DCO are homeostasis, debridement, fracture fixation, and wound coverage once the patient is stabilized from their traumatic injuries.

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    Damage Control Orthopedic - ASW

    Uploaded by

    Aisyah Khumairah
    95 views32 pages
    The document discusses pathophysiology and damage control orthopaedics (DCO) in trauma patients. It notes that there are three peak times of death after trauma: within minutes due to blood loss or neurologic injury, within days due to shock/hypoxia/neurologic injury, and within weeks due to multi-system organ failure or infection. DCO aims to control hemorrhage, remove dead tissue to prevent further injury, and relieve pain to facilitate intensive care, rather than immediately fixing all fractures which could be harmful for multiply injured patients. The goals of DCO are homeostasis, debridement, fracture fixation, and wound coverage once the patient is stabilized from their traumatic injuries.

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    damage kontrol

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    The document discusses pathophysiology and damage control orthopaedics (DCO) in trauma patients. It notes that there are three peak times of death after trauma: within minutes due to blood loss or neurologic injury, within days due to shock/hypoxia/neurologic injury, and within weeks due to multi-system organ failure or infection. DCO aims to control hemorrhage, remove dead tissue to prevent further injury, and relieve pain to facilitate intensive care, rather than immediately fixing all fractures which could be harmful for multiply injured patients. The goals of DCO are homeostasis, debridement, fracture fixation, and wound coverage once the patient is stabilized from their traumatic injuries.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    95 views32 pages

    Damage Control Orthopedic - ASW

    Uploaded by

    Aisyah Khumairah
    The document discusses pathophysiology and damage control orthopaedics (DCO) in trauma patients. It notes that there are three peak times of death after trauma: within minutes due to blood loss or neurologic injury, within days due to shock/hypoxia/neurologic injury, and within weeks due to multi-system organ failure or infection. DCO aims to control hemorrhage, remove dead tissue to prevent further injury, and relieve pain to facilitate intensive care, rather than immediately fixing all fractures which could be harmful for multiply injured patients. The goals of DCO are homeostasis, debridement, fracture fixation, and wound coverage once the patient is stabilized from their traumatic injuries.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 32

    Pathophysiology

    in Trauma and
    Damage Control
    Orthopaedic

    Putu Astawa
    Introduction
     Trauma is a major public health problem with high
    disability, death, and societal cost
     Three peak times of death after trauma
     50% within the first minutes of sustaining the injury
     caused by massive blood loss or neurologic injury
     30% within the first few days
     most commonly from shock, hypoxia, or neurologic injury
     20% within days to weeks following injury
     multi system organ failure and infection are leading
    causes
    Three peak times of death
    Triad of death
    Introduction
     Many orthopaedic patients who have sustained
    multiple injuries benefit from the early total care
    of major bone fractures.

    Best option??
    Introduction
     Early total care of major bone fractures  is not the best
    option, and indeed might be harmful, for some multiply injured
    patients.

    Damage control orthopaedics


    History
    Physiology of Damage Control Orthopaedics

     After trauma, there is a


    balance between the
    systemic inflammatory
    response (SIRS) and the
    counter regulatory anti-
    inflammatory response
    (CARS).

    A lesser inflammatory
    Severe inflammation
    response + excessive CARS

    acute organ failure and early prolonged


    death. immunosuppressed state
    WRONG!!!
    Host Response

     Cytokines  Reactive oxygen species


     Leukocytes  Eicosanoids
     Endothelium  Microcirculatory disturbances
     Subsequent leukocyte-
    endothelial cell interactions
    Patient
    Selection
    Timing and Priorities of Surgery

    Primary Objective

    • survive with normal function.

    First priority is resuscitation

    • ensure adequate perfusion and oxygenation of all


    vital organs.

    If there is no response

    • immediate live-saving surgery.


    • Decompression body cavity
    • Control of hemorrhage
    Timing of Surgical Intervention
    General Aims and Scopes of Fracture
    Management in Multitrauma

     Control of hemorrhage.
     Control of sources of contamination, removal of dead
    tissue, prevention of ischemia-reperfusion injury.
     Pain relief.
     Facilitation of intensive care.

    Homeostasis, debridement, fasciotomy, fracture


    fixation, and tension-free wound coverage.
    Summary
    Summary
    Summary

    DCO Current Concept


    THANK
    YOU

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