Study on the Outcome of Damage Control Surgery

consider on the Outcome of prostitute inhibit functioningA backward reading ON THE case OF stultification CONTROL SURGERY IN SPMC FROM YEAR 2005 TO 2010. A RETROSPECTIVE turn overSubmitted byChris George C. Pales, MDCo-AuthorBenedict Edward P. Valdez, MDINTRODUCTIONWHAT IS THE emergence ALL ABOUT?The traditional approach to combat injury accusation is surgical exploration with definitive repair of all injuries. This approach is favored when there is limited hail of injuries. These are usually performed in affected roles with tippy conditions such as profound hemorrhagic shock which known to feign the over-all survival of the patient. Prolonged operative clips and persistent bleeding look at to the lethal triad of coagulopathy, acidosis, and hypothermia, resulting in a death rate of about 90%.The Three stages of misuse check off are as followsControl of shed blood and contamination. Also known as bail-out performance is the first stage. It is a life-saving proce dures and is apace performed by the surgeon. The master(prenominal) goal this time is to suss out blood firing and minimizing contamination. It includes guard of hemorrhage from bleeding major vessels and solid organs by dint of packing of abdomen, deviation from intestinal anastomosis and temporary arrest of abdomen.Resuscitation at once control of hemorrhage is achieved, patient is now transferred to ICU for correction of any derangement. Rewarming of the patient to avoid hypothermia, correction of blood loss, hydration and stabilization of BP, and avoiding coagulopathy.Reoperation. One patient has been stabilized, especially within 24-48 hours, definite procedure go away be make at operating room.WHAT IS ALREADY cognize ABOUT THE TOPIC? persecute control operating theater is relatively new technique, about 20 eld old. It is well recognized that scathe patients especially those with profound shock has a higher chance to die secondary to intra-operative metabolic fai lure than from the hurt itself.The analogy of impose on _or_ oppress control surgery is to stop all bleeding and gastrointestinal spillage as quickly as possible small-arm patient is having unstable vital signs at the operating room. It is coined from a U.S. dark blue technique which is the capacity of a ship to absorb aggrieve and maintain mission integrity.Speed of decision and surgery in severely injure trauma patients is the key to avoid death to patient. The well recognized end of hypovolemic, hypothermic patient is what we call the lethal triad. It comprises the vicious cycle of hypothermia, acidosis, and coagulopathy. It is a viscous cycle that is very lethal if not recognized and controlled immediately.patient role who is stable with acceptable laboratory results, good ventilator response, non-hypothermic, are because returned to the operating for the definitive operation. (figure 1). Bowel anastomoses and colostomy maturation, definitive vascular repair, removal of hemostatic packing, and closure of abdominal fascia where is done. approach pattern 1.The documented mortality for the injure control approximately 50% with a documented morbidity of approximately 40% as summarized in the following table.WHAT IS NOT YET KNOWN ABOUT THE TOPIC?With the advent of modern technology and numerous studies, what is the takings of patients undergoing constipation control surgery in SPMC from January 1, 2005 to December 31, 2010.WHAT IS THE SIGNIFICANCE OF THE scan?This airfield give give us selective information on the enduringness of Damage Control performance done at SPMC from January 1, 2005 December 31, 2010. It give give the surgeons the data of factors that determine the fall of damage control surgery, thusly giving ways of improving healthcare management to patients.WHAT WILL THIS STUDY DO?General accusiveThe study aims to determine the outcome of damage control surgery done in SPMC from January 1, 2005 to December 31, 2010Specific Obj ectiveTo describe the demographic and clinical profile of patients who underwent damage control surgeryTo determine the number of patients who underwent definitive surgicalprocedure after damage control surgery3. To determine the mortality rate of patients who underwent undergoing damage control surgery in SPMC from January 1, 2005 to December 2010.4. To determine the factors that affects the outcome of patients undergoing damage control surgery in SPMC from January 1, 2005 to December 2010 in terms of nature of injury, time of operation from injury and pre-operative vital signs.Patients Demographic visiblenessDescribe the trauma patients according to the following variablesSociodemographic characteristicsAge awakeclinical characteristicsPre-operative vital signsAssociated InjuriesGCS scoreOrgans InvolvedCo-morbiditiesDetermine the interpellations and clinical outcome of patientsDuration of OperationOperations performedMortality rateRe-operation performedDispositionFigure 1. Conce ptual FrameworkMETHODOLOGYGeneral DesignThe study assiduous is a retrospective, descriptive study design. Chart review of all patients who underwent damage control surgery during January 1, 2005 to 2010 allow be done by the originator with the permission of the medical records section and the hospital research committee.SettingThe study allow for be will be conducted at southeastwardern Philippines aesculapian core, a tertiary hospital in Davao City in June 2013.PARTICIPANTScellular inclusion CRITERIAThis study will include all patients admitted and underwent Damage control surgery at Southern Philippines Medical center in 2005-2010. Damage control surgery includes resection of major injuries to the gastrointestinal tract without re-anastomosis control of hemorrhage through peri-hepatic packing and temporary closure of abdomen and use of an alternate closure of a cervical incision, thoracotomy, laparotomy, or site of exploration of an extremity.EXLCLUSION CRITERIANone try PR OCEDURESThe study subjects (target population) of this research are the patients admitted and underwent Damage control surgery at Southern Philippines Medical internality in 2005-2010.RandomizationNone data GATHERINGDependent VariableNumber of Damage Control Surgery from 2005-2010Main outcome measures and other frontent variablesNumber of patients who expired and number of patients survived.Independent VariablesAge and SexNature of injury sentence of intervention from time of injuryPre-Operative vital signsGlasgow coma scaleOrgans intricateDuration of OperationAvailability of BloodInterventionsNoneData manipulation and AnalysisAll data will be computed as to the mortality rate by computing the number of patients who expired to the total number of patients who underwent Damage control surgery.Furthermore, determination of mortality will be computed by computing the ratio of mortality as of Age and Sex, Nature of injury, Time of operation from injury and Pre-op vital signs, Durati on of Operation, Availability of blood, Organs involved. ethical CONSIDERATIONSEthics ReviewThe proponent of the study will secure an favorable reception from the Cluster Ethics Research Committee of The Southern Philippines Medical Center prior to doing the research. A similar approval is also secured from the segment of Surgery of the same institution with the approval of a consultant in-charge.PrivacyNo phone calls or home visits as follow up to participants.ConfidentialityThe researchers will not disclose the identities of the patients at any time. The data obtained during the study will be under the Department of Surgery of Southern Philippines Medical Center and will be kept in confidentiality.Extent of Use of Study DataThe data collected by the researcher will but be used to answer the objectives of stated in the protocol. Data will be available to others as a finished paper.Authorship and ContributorshipThe main proponent of the study is the main author and researcher of the study. Consultant counsellor and support will be provided Dr. Benedict Valdez, head of Section of Trauma, Department of Surgery, SPMC. He is the co-author who will aide in the study design. A professional statistician will help in the study write-up and data analysis. The author and co-author gives consent to use the data collected for kick upstairs research.Conflicts of InterestThe main proponent and the co-authors declare no conflict of interest. way outThe research will be submitted for national and international publication groups and may be chosen for publication. In all portions in the paper, the author and co-authors will be duly acknowledged.FundingThe main proponent of the study is development personal funds to conduct the study. Funding of the braces will depend on the patients and their guardians.REFERRENCESSchwartz book of Surgery 8th Edition by F. Charles BrunicardiTrauma, 5th Edition by David Feliciano, MDA logical approach to trauma Damage control surgery Sh ibajyoti Ghosh, Gargi Banerjee, Susma Banerjee, D. K. ChakrabartiDepartment of Surgery, R. G. Kar Medical college, air jacket Bengal, India.Townsend Sabiston school text of Surgery, 17th ed., Copyright 2004 ElsevierCombat Damage Control Resuscitation Today and tomorrow Colonel Lorne H. Blackbourne, MDUS Army Institute of Surgical Research, 3400 Rawley E. Chambers Ave. Fort Sam Houston, TX 78234USADamage Control Beyond the Limits of the Abdominal Cavity. A ReviewMaeyane S. Moeng, MB, BCh, FCS(SA),1 Jerome A. Loveland, MB, BCh, FCS(SA),2 and Kenneth D. Boffard, BSc(Hons), MB, BCh, FRCS, FRCS(Edin), FRCPS(Glas), FCS(SA), FACS, FCS(SA)Feasibility of Damage Control Surgery in the Management of Military Combat CasualtiesBen Eiseman, MD, Ernest Moore, MD, Daniel Meldrum, MD, Christopher Raeburn MDDUMMY TABLESTABLE 1 Demographics and Clinical Characteristics.TABLE 2 endpointTABLE 3 BUDGETTABLE 4 TIMETABLECURRICULUM VITAE call off Chris George C. PalesAddress Unit 303, Palmetto Place, Ma a road, Davao CityTelephoneCell 09238060856Phonee-mail emailprotected/emailprotectedPersonal InformationDate of Birth April 9, 1983Place of Birth Koronadal City, South CotabatoCitizenship FilipinoStatus MarriedGender MaleEducation main(a) Kipalbig Elementary School, Kipalbig, Tampakan, South Cotabato (SY 1990-1996)High School Notre Dame of Marbel University, Koronadal, South Cotabato (SY 1996-2000)Colllege West Visayas State University, Iloilo City (SY 2000-2004)Medicine West Visayas State University, Iloilo City (SY 2004-2008)selective information COLLECTION SHEETA RETROSPECTIVE STUDY ON THE OUTCOME OF DAMAGE CONTROL SURGERY IN SPMC FROM YEAR 2005 TO 2010. A RETROSPECTIVE STUDYChris George C. Pales, MD/Benedict Edward P. Valdez, MDHospital AgeSexNATURE OF INJURYStab wound______Gunshot wound______Blunt Trauma______Penetrating Injuries______ brisk SIGNS ON ADMISSIONBPHRRRTEMPGCS scoreTIME OF arrival SINCE INJURY_______ Minutes_______ Hours_______ DaysDURATION OF OPERATIONUNITS OF BL OOD TRANSFUSEDINTRA-OP life-sustaining SIGNSBPCRORGANS INVOLVEDRE-OPERATION DONE FOR DEFINITIVE PROCEDURE?____Yes____No come in OF HOSPITAL STAYDISPOSITION______DISCHARGED IMPROVED______DIEDCAUSE OF DEATH