Division of Trauma and Acute Care Surgery John Holcomb, M.D., FACS, published “Damage control laparotomy in trauma: a pilot randomized controlled trial,” in the Trauma and Acute Care Surgery Open journal.
Holcomb published the article alongside first author John Harvin, M.D. and colleagues from The University of Texas Health Science Center at Houston Department of Surgery.
According to the authors, when a patient experiences severe abdominal trauma–like massive liver injuries, pelvic trauma, and retroperitoneal injuries–one technique that providers use to treat the abdominal trauma is the damage control laparotomy (DCL) procedure.
Mortality for this group of patients remains high but some can be saved using staged abdominal reconstruction for trauma. A DCL focuses on stopping bleeding, replacing lost blood with blood products along with correction of hypothermia, optimization of oxygen transport, and selected abdominal packing.
The authors assert that although widely used in treating severe abdominal trauma, DCL has not ever been assessed in a randomized controlled trial. So, they conducted a pilot trial among patients who would receive either a DCL or a similar treatment for severe abdominal trauma, called definitive laparotomy (DEF).
Researchers conducted the first randomized trial of a DCL vs a DEF, enrolling 39 patients from July 2016 to May 2019, and their findings of their single center pilot trial were inconclusive. Outcomes were not worse with DCL and in fact, may have been better with DEF.
Authors believe the next step is a larger, multicenter trial to compare DCL and DEF for patients with severe abdominal trauma.
“It was an honor to represent the UAB Center for Injury Science in this publication,” said Holcomb. “Our mission is to conduct high quality research that helps improves outcomes from injury at all stages of care, from the prehospital setting through to resuscitation, acute care and rehabilitation, and this study did just that.”
To see a full list of authors and complete study methods, click here.