JOURNAL TOOLS |
Publishing options |
eTOC |
To subscribe |
Submit an article |
Recommend to your librarian |
ARTICLE TOOLS |
Publication history |
Reprints |
Permissions |
Cite this article as |
Share |
YOUR ACCOUNT
YOUR ORDERS
SHOPPING BASKET
Items: 0
Total amount: € 0,00
HOW TO ORDER
YOUR SUBSCRIPTIONS
YOUR ARTICLES
YOUR EBOOKS
COUPON
ACCESSIBILITY
REVIEW Open access
Minerva Surgery 2023 December;78(6):692-709
DOI: 10.23736/S2724-5691.23.09916-1
Copyright © 2023 THE AUTHORS
This is an open access article distributed under the terms of the CC BY-NC 4.0 license which allows users to distribute, remix, adapt and build upon the manuscript, as long as this is not done for commercial purposes, the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI), provides a link to the license and indicates if changes were made.
language: English
Debunking the lethal triad and delineating damage control surgery
Fabrizio G. BONANNO ✉
Department of Surgery, Polokwane Provincial Hospital Cnr Hospital, Polokwane, South Africa
The last three decades of literature in trauma have been erroneously hammered by the belief the lethal triad (LT) of acidosis, hypothermia and coagulopathy was, as claimed originally, the statutory rationale underlying for the application of damage control surgery (DCS) strategy. As a matter of fact, the LT is not all lethal: only acidosis is lethal and a reliable hard sign for DCS, indicating severe levels of hypoxemia and tissues hypoxia. The mainstream flow of events leading to exitus in hemorragic shock pass through macro and microcirculation dynamics, oxygen, acidosis, and ischemia-reperfusion toxemia. It is solely by interfering or manipulating these variables dynamics that we can decrease morbidity and mortality. A solid synoptic list of the indications and timing of DCS has been elaborated.
KEY WORDS: Hypothermia; Blood coagulation disorders; Surgery