Published online Jan 18, 2019. doi: 10.5312/wjo.v10.i1.1
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: 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.