damage control surgery in developing country
The concept of damage control surgery was a revolution in managment of patient having very poor prognosis specially management of trauma patients.generally teh concept evolves around a two stage procedure while taking care of potential hypothermia,coagulopathy,etc.
In developing countries like a city name sargodha in pakistan the concept of damage control is further modiefied (actually beacuse of decreased resources),and the two stage procedure are done but there is no availability of surgical ICU,so the patients for example with sever liver injury are operated and in case of grade 3 or grade 4 injury only a huge pack is placed in the liver area.
The patient then is shofted to normal ward with routine monitoring and lator is opened again after 48 hrs .Around 50 percent of patients do have adequate hemostasis and survive teh catastrophic trauma,initially thought to be a case of 100 percent mortality.
Though a lot can be improved but already encouraging results are observed with these modifeid or compromised procceedings.
dochassan 
Informative. Needs prof read once at least!
thanks ,and point taken nab
For smaller set ups like ours, small but innovative changes like those mentioned can certainly help. I will really support these measures even if one life is saved,that is otherwise dying of poor prognosis
Good start and best of luck
thanks,,i appreciate
The concept is good but the need of tertiary care hospital with all the facilities of managing trauma cannot be denied.what we really need in sargodha is the concept of advanced trauma life support expertise n facilities thereof .My suggestion in this regard would be that with limited resources you can make a team of say may be 6-7 people who get ATLS certified from good tertiary care setups and i think if initial management in the secondary/primary care is taken care of we can definitely reduce the morbidity and mortality.regarding damage control you can do audit of these patients and see what happened in long term followup of these patients even if they survive the initial catastrophe but still if it works in the immediate management u can publish your results of immediate outcomes of damage control strategy ..
Hey there nadz.
absolutely.. trauma is the biggest killer of human below the age of 40.. and the need of tertiary care hospital is as important as other basic necessaties of human being like food…but as u know the way things go in paksitan …health care is deterioting very rapidly ,and all the managment has to be tailored. As far as maing a team of 6 or 7 people is concerned it again is a great idea but again the problem is of human resource ..getting the training comes after that 🙂
nonetheless thanks for awsome suggestions nadz.
v nice work sir but there are some spelling mistakes
firtly thanks and yes u are right will look into it .thanks for posting
Nice sirr….
Thanks aiman
Really a very nice effort for a place like our DHQ……..It was indeed needed to have a plateform where we get proper guidance and help regarding the curriculum and also the surgical skills……..we the student dont even have an idea about the the basic emergency management of trauma patients……..sir you kindly start student tarining on this plateform initially by the animated videos and the easy,compreensive reading material……for those not interested in surgery as proffesion you should guide them regarding the surgery curriculum and the sort of first aid techniques needed in day to day life…….and also divide the blog in different sections according to the readers different thoughts of interest…….may this blog flourish to the sky high levels in a very short time
Thanks faiza,,, i am already on few of the suggestions and will come up with better options INSHALLAH