Ann Med Med Res | Volume 6, Issue 1 | Research Article | Open Access
Jia J1*, Zhang Y1*, Wang L2, Feng B3, Sun H1, Jin W1, Ma D1, Dong Y2, Kuang P3 and Zhang Q3
1Department of General Surgery, General Hospital of Central Theater Command of PLA, China
2The First School of Clinical Medicine, Southern Medical University, China
3Wuhan University of Science and Technology School of Medicine, China
*Correspondance to: Jiankun Jia
Fulltext PDFIntroduction: To investigate the effect of Damage Control Surgery (DCS) on the clinical outcomes
and Heat Shock Protein (HSP) expression of patients with severe traumatic liver rupture.
Materials and Methods: A randomized control study was conducted on 43 patients with severe
traumatic liver rupture enrolled into our institute from January 2020 to June 2021. Twenty-five
patients were assigned to Damage Control Surgery (DSC) group and 18 patients were assigned
Early Comprehensive Treatment (ETC) group according to sample size calculation. The differences
in clinical characteristics including intraoperative bleeding, operative duration, and length of
hospitalization, postoperative complications, morbidity and mortality rates, and HSP expression
were compared.
Results: Among 25 patients, there is 1 death (4%) and 24 successful resuscitation cases in the DSC
group. The rate of resuscitation in DSC group was significantly higher than that of the ETC group
(P<0.05). Intraoperative bleeding and operative time in the DCS group were (972.3 ± 87.6) mL
and (105.4 ± 24.7) min, respectively, which were significantly lower than those in the ETC group
(P<0.05 for both). The levels of Lactate (Lac), PT, APTT and TT were significantly decreased in both
groups after surgery (P<0.05) compared to before, and the differences were statistically significant
in the DCS group compared with the ETC group in these indexes (P<0.05). Compared with the
preoperative period, HSP60, HSP70 and HSP90 were significantly lower in both groups, and
the DCS group was significantly lower than the ETC group in these three postoperative indexes
(P<0.05). In terms of postoperative biliary fistula, liver abscess and re-bleeding, the DCS group had
significantly less incidences than the ETC group (P<0.05).
Conclusion: DCS is more effective in improving coagulation and Lac accumulation in patients with
severe traumatic liver rupture, leading to a decrease in intraoperative bleeding and a reduction in
perioperative complications, thus leading to a significant increase in the success rate of salvage.
Meanwhile, HSP60, HSP70 and HSP90 expressions were significantly lower in DCS patients.
Damage control surgery; Traumatic liver rupture; Heat shock protein
.