The damage control sequence and underlying logic

The damage control approach evolved out of a need to develop new ways in managing exsanguinating torso injuries. The underlying rationale is based on an understanding of the pathophysiology of metabolic acidosis, hypothermia, and coagulopathy. Rapid termination of exploratory laparotomy after initial control of hemorrhage and contamination breaks the lethal physiologic cycle of death by exsanguination. Aggressive resuscitation followed by reoperation leads to an increased survival rate.