Doing damage control: the extreme demands that exsanguinatung haemorrhage puts on both surgeons and engineers

摘要

Damage control is a naval term originally used to describe emergency procedures done at sea following major ship damage in order to prevent her total loss and enable her to get to port where definitive repairs can be carried out. The concept has also been applied in trauma surgery, where control of massive bleeding, and then resuscitation of the patient in a critical care environment, are necessary before embarking on other types of surgical procedures that may take longer and are less time-critical. Controlling major haemorrhage is often very challenging for the surgeon. It is also an extreme situation for instruments and materials, which must be rapidly utilised and effective even when immersed in blood that is unable to clot normally. This presentation takes the audience through the operative control of major haemorrhage and the challenges faced that are engineering opportunities. With reference to key developments in novel haemostatic dressings, devices and surgical techniques, how effectiveness is assessed will be discussed, as will the challenges of clinical translation. In that regard the presentation represents a conversation between a surgeon and a materials science engineer, in which the convergence of ideas is critical to developing effective life-saving solutions.