Interventional and operative procedures in complex and poly-trauma
Previously any general surgeon could practice trauma as the approaches to even complex trauma were straightforward: open the appropriate body cavity, identify the bleeding organ, and repair the damage. The high morbidity and mortality associated with this approach has given way to new concepts and techniques. Resuscitative thoracotomy has in part been replaced by resuscitative endovascular balloon occlusion of the aorta (REBOA). The approach to hemorrhage associated with complex pelvic fractures has evolved with the addition of REBOA, and preperitoneal pelvic packing (PPP). Damage control laparotomy (DCL) has been utilized less frequently thanks to better resuscitation. The evolution of these techniques has guided trauma surgery to becoming a distinct specialty.