Patients
bleeding, hypothermia, traumatic injuries, hemoperitoneum, hyperlactatemia, abdominal injuries, intra-abdominal organ injuries, DCL, metabolic acidosis, trauma
METABOLIC ACIDOSIS, BLEEDING, HEMOPERITONEUM
Adult patients with traumatic injuries were eligible for the study if they were to undergo damage control abdominal surgery in the index laparotomy. Specific inclusion criteria were: 1. informed consent obtained before any trial-related activities, 2. age above or equal to 18 years at the time of inclusion, and 3. patients with blunt or penetrating trauma and requiring DCL for abdominal injuries. The decision to perform an emergent laparotomy was taken by the attending trauma surgeon at the emergency department in patients with signs of exsanguination/hemodynamic instability, acute abdomen or evisceration. When in the operating room, patients underwent a DCL (involving surgical control of bleeding and contamination plus packing with laparotomy pads plus leaving the abdominal wall open) if there was evidence of hypothermia, metabolic acidosis or hyperlactatemia (reflecting physiological exhaustion), hemoperitoneum and/or destructive intra-abdominal organ injuries. A detailed description on how we approach and provide surgical treatment to patients with abdominal injuries requiring damage-control surgery at our institution is described elsewhere [