Editorial
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2019; 10(1): 1-13
Published online Jan 18, 2019. doi: 10.5312/wjo.v10.i1.1
Damage control orthopaedics: State of the art
Enrique Guerado, Maria Luisa Bertrand, Juan Ramon Cano, Ana María Cerván, Adolfo Galán
Enrique Guerado, Maria Luisa Bertrand, Juan Ramon Cano, Ana María Cerván, Adolfo Galán, Department of Orthopaedic Surgery and Traumatology, Hospital Costa del Sol, University of Malaga, Marbella 29603, Malaga, Spain
Author contributions: Guerado E conceived the paper, wrote the general section, reviewed the manuscript and presented the final version; Bertrand ML wrote the text on pharmacology treatment; Cano JR discussed pelvic fractures; Cerván AM addressed spinal fractures; and Galán A focused on upper limb injuries; all authors approved the final version.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Enrique Guerado, BSc, DPhil, FRCS (Hon), MD, MSc, PhD, Chief Doctor, Department of Orthopaedic Surgery and Traumatology, Hospital Costa del Sol, University of Malaga, Autovía A-7, Km 187, Marbella 29603, Malaga, Spain. eguerado@hcs.es
Telephone: + 34-951-976224 Fax: + 34-951-976222
Received: September 29, 2018
Peer-review started: September 29, 2018
First decision: November 14, 2018
Revised: December 11, 2018
Accepted: December 12, 2018
Article in press: December 13, 2018
Published online: January 18, 2019
Core Tip

Core tip: Damage control orthopaedics (DCO) is the treatment of lesions that provoke major bleeding and pathological inflammatory response, whilst avoiding the traumatic effects of major surgery in a patient who is already traumatised (the “second hit” effect). The concept of DCO has not previously been validated and much controversy remains as to whether the indiscriminate application of DCO might be clinically and economically harmful. In addition, parameters associated with the acid-base system have been published with the idea that the existence of normalised parameters will enable patients to receive major surgical procedures, under a concept termed early appropriate care. This paper discusses the above concepts.