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Maxillofacial and neck trauma: a damage control approach

机译:颌面部和颈部外伤:一种损伤控制方法

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Severe maxillofacial and neck trauma exposes patients to life threatening complications such as airway compromise and hemorrhagic shock. These conditions require rapid actions (diagnosis and management) and a strong interplay between surgeons and anesthesiologists. Effective airway management often makes the difference between life and death in severe maxillofacial and neck trauma and takes initial precedence over all other clinical considerations. Damage control strategies focus on physiological and biochemical stabilization prior to the comprehensive anatomical and functional repair of all injuries. Damage control surgery (DCS) can be defined as the rapid initial control of hemorrhage and contamination, temporary wound closure, resuscitation to normal physiology in the intensive care unit (ICU) and subsequent reexploration and definitive repair following restoration of normal physiology. Damage control resuscitation (DCR) consists mainly of hypotensive (permissive hypotension) and hemostatic (minimal use of crystalloid fluids and utilization of blood and blood products) resuscitation. Both strategies should be administered simultaneously in all of these patients.
机译:严重的颌面部和颈部外伤使患者面临危及生命的并发症,例如气道受损和失血性休克。这些情况需要迅速采取行动(诊断和处理),并且外科医生和麻醉师之间必须密切配合。有效的气道管理通常会在严重的上颌面部和颈部创伤中使生与死有所作为,并且首先要优先于所有其他临床考虑因素。损伤控制策略的重点是在对所有损伤进行全面的解剖和功能修复之前,先进行生理和生化稳定。损害控制手术(DCS)可以定义为快速初步控制出血和污染,临时闭合伤口,在重症监护病房(ICU)中恢复正常生理状态,以及随后恢复正常生理状态后进行的彻底恢复和最终修复。损伤控制复苏(DCR)主要包括降压(允许性低血压)和止血(最少使用晶体液以及利用血液和血液制品)复苏。所有这些患者均应同时使用两种策略。

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