Damage control: what is its role in colorectal surgery?

Damage control is an approach that has gained widespread popularity and acceptance in the management of severely injured patients. Although initially popularized in the trauma literature, this technique is being expanded to the management of a broad range of serious, often desperate surgical circumstances that may be encountered, including scenarios confronted by the colon and rectal surgeon. Damage-control surgery is a three-staged process involving a truncated laparotomy, aggressive resuscitation in the intensive care unit, and finally, definitive surgery. This approach may be lifesaving in the setting of presacral hemorrhage, severe coagulopathy, or patient instability.