Medical aspects of terrorist bombings: A focus on damage control surgery and damage control resuscitation

Ventsislav M Mutafchiyski; Georgi I Popivanov; Kirien C Kjossev

doi:10.1186/2054-9369-1-13

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Medical aspects of terrorist bombings: A focus on damage control surgery and damage control resuscitation

REVIEW | Updated：2026-03-12

- Medical aspects of terrorist bombings: A focus on damage control surgery and damage control resuscitation
- Military Medical Research Vol. 1, Issue 2, Pages: 103-108(2014)
- Affiliations：
  
  1.Endocrine Surgery and Coloproctology, Military Medical Academy, Sofia, Bulgaria
  2.Clinic of Abdominal Surgery, Military Medical Detachment of Emergency Response, Military Medical Academy, Sofia, Bulgaria
  3.Clinic of Abdominal Surgery, Military Medical Academy, Sofia, Bulgaria
- Author bio：
  
  *: gerasimpopivanov@rocketmail.com
- Funds：
- DOI：10.1186/2054-9369-1-13
  CLC：
- Published：2014-06
- Accepted：
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Mutafchiyski et al.: Medical aspects of terrorist bombings – a focus on DCS and DCR. Mil Med Res 2014, 1: 13
DOI：

Mutafchiyski et al.: Medical aspects of terrorist bombings – a focus on DCS and DCR. Mil Med Res 2014, 1: 13 DOI： 10.1186/2054-9369-1-13.

摘要

Abstract

Although terrorist bombings have tormented the world for a long time

currently they have reached unprecedented levels and become a continuous threat without borders

race or age. Almost all of them are caused by improvised explosive devices. The unpredictability of the terrorist bombings

leading to simultaneous generation of a large number of casualties and severe "multidimensional" blast trauma require a constant vigilance and preparedness of every hospital worldwide. Approximately 1.0%-2.6% of all trauma patients and 7% of the combat casualties require a massive blood transfusion. Coagulopathy is presented in 65% of them with mortality exceeding 50%. Damage control resuscitation is a novel approach

developed in the military practice for treatment of this subgroup of trauma patients. The comparison with the conventional approach revealed mortality reduction with 40%-74%

lower frequency of abdominal compartment syndrome (8%

16%)

sepsis (9%

20%)

multiorgan failure (16%

37%) and a significant reduction of resuscitation volumes

both crystalloids and blood products. Damage control surgery (DCS) and damage control resuscitation (DCR) are promising new approaches

contributing for the mortality reduction among the most severely wounded patients. Despite the lack of consensus about the optimal ratio of the blood products and the possible influence of the survival bias

we think that DCR carries survival benefit and recommend it in trauma patients with exsanguinating bleeding.

关键词

Keywords

references

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