Damage control. The history and modern view on surgical tactics

Introduction. The development of means and methods for the emergency elimination of vital disorders at the stages of intensive care helps to reduce mortality, however, even the use of the latest medical equipment does not guarantee the successful outcome of surgical measures, if this does not take into account the regular features of the course of vital processes in conditions of traumatic shock, the stage of development of traumatic illness. The polysystemic and multiorgan nature of lesions in polytrauma determines the variability of measures to provide medical care to the victims. This is due to the lack of a standardized treatment program for such patients at the hospital and pre-hospital stages. The second reason is the fragmentation and inconsistency of data on this topic. A systematic approach that would fully reflect the specifics of the lesions, taking into account the damaged organs and systems, the severity of the condition and the degree of organ dysfunction, is currently in its infancy. Surgical tactics for the treatment of patients with severe injuries does not have clear algorithms. For more than a century, generalized algorithms of surgical tactics have been helping surgeons, resuscitators and other specialists optimize the processes of polytrauma treatment, save the lives of patients who were previously considered hopeless.The purpose of this article is to present an analytical review of the surgical tactics for the treatment of polytrauma at the hospital stage, which has received the generally accepted name "damage control surgery" or "surgical damage control" based on scientific literature.Materials and methods. The analysis of domestic and foreign literary sources by keywords on available Internet resources was carried out. More than 60 scientific publications were studied, 39 of them are listed in this article.Conclusion. Surgical tactics "Damage control surgery" determines the prospect of reducing the mortality of patients with severe traumatic shock and decompensated blood loss. At the same time, there is an increase in the percentage of survival and an improvement in the long-term results of surgical treatment of patients with severe trauma to the abdomen, chest, pelvis, craniocerebral trauma, combined with damage to tubular bones.At the same time, the number of postoperative complications remains high, clear indications for the use of multi-stage surgical tactics have not been determined, and the optimal timing for performing the stages of surgical treatment has not been determined.