Vascular Damage Control

Purpose of Review: This article reviews vascular damage control, with a focus on the importance of immediate hemorrhage control, indications for damage control surgery rather than definitive repair, and methods of hemorrhage control including temporary shunting to maintain distal perfusion, simple ligation, or immediate reconstruction, as well as prioritizing temporary or definitive vascular repair in the setting of multisystem trauma in the care of the injured patient. Recent Findings: The indications and methods of damage control surgery in vascular trauma continue to evolve. The importance of early hemorrhage control is well known as a preventable cause of mortality related to hemorrhagic shock, but decisions regarding the practice of damage control, including ligation, shunting, and definitive repair continue to be a subject of debate in the literature. It is the purpose of this text to discuss the current practice of damage control regarding vascular trauma. Summary: Vascular damage control is an essential part of damage control surgery. Ligation and intravascular shunting are the primary options and should be applied to patients requiring damage control, to those with combined vascular and bony injuries, and for those surgeons where definitive reconstruction is beyond their skillset.