Abbreviated laparotomy

The decision to perform damage control laparotomy in a critically injured p atients depends on the risk of life-threatening coagulopathy. The main deci sion criteria are: presence of concomant injuries, patient history, shock, transfusion volume, hypothermia and acidosis. The aim of surgery is to achi eve satisfactory hemostasis, limit peritoneal thermal loss, and perform phy siological restoration as rapidly as possible in the intensive care unit. T his includes gauze packing major liver or retroperitoneal injuries and liga tion of injured blood vessels. Injuries to the intestine and the urinary tr act are sutures, stapled or drained. If the skin borders cannot be approxim ated because of excessive abdominal tension, a wall prosthesis should be us ed to avoid abdominal compartment syndrome. Reoperation is a dangerous proc edure in the immediate postoperative period but must be proposed later for reexploration or damage repair.