Feasibility of damage control surgery in the management of military combatcasualties

Unique and expanded applications of staged operative management are undergo ing careful evaluation in many civilian level 1 trauma centers under the ru bric of damage control surgery. Recently there have been advocates for its broad application to the early management of critically injured combat casu alties. However, the enormous logistic requirements for such strategics are contrary to the demands of the usual wartime scenario. On the basis of exp erience in civilian trauma centers and combat casualty management, we quest ion the suggested extensive role of damage control surgery during wartime. Each decision point in damage control surgery should be analyzed as it is a ltered (sensitivity analysis) by conditions of war. It is unwise to adopt s uch indications unchanged from current civilian trauma policy.