ABSTRACT
The decision to undergo damage control should be made early in the operative process. This decision may even be made prior to patient arrival based upon information transmitted by EMS during transport. While prehospital hypotension can be resolved with resuscitation, it should be considered a warning of the patient being more severely injured and potentially unprepared for a prolonged operation.(16) In theory, a damage control laparotomy should last less than 90 minutes.(17) Thus, consideration of damage control should be made prior to physiological exhaustion and presentation of hypothermia, acidosis, or coagulopathy. Waiting for development of this lethal triad will reduce the likelihood of salvage (Table 19.1).
