Misunderstanding duodenal repair

[Christos Giannou]

Querido Porfirio,

Quote
Because I´m fast and have a reliable team ? etc.
Dr Porfirio Lango
General/Trauma Surgeon
Mazatlan Sinaloa Mexico
unquote

I am afraid that you did not understand my question. I have been doing war
surgery for 28 years, there was no "damage control" when I started, and I
still use ONLY whole blood. In the bush in the Congo or Somalia or Nepal,
there are no blood components available.  Staplers are expensive and in the
International Committee of the Red Cross hospitals we NEVER have them.

My question concerned the philosophy and methodology of damage control. If
you are going to go that route, then, in my understanding (we are both "old
school" surgeons) you control haemorrhage and contamination first. Stop.
Finish the stabilisation in the ICU. Then repair at a second operation. If
you are doing everything at one sitting, it is no longer "damage control",
whether you close the abdomen with a Bogotá bag or not.

mejores salutaciones
-- 
christos giannou
Monemvasia Lakonia
23070 Greece
tel & fax: (++30) 27320-61772
mob: (++30) 69 74 83 28 18