In an emergency surgery may require damage control for the management of a non-trauma patient.

A typical patient has significant disease of the small and/or large intestine. Many of the patients are classified as ASA 4 or 5.


Staged rapid source control laparotomy involves a deliberate plan to:

(1) perform an immediate, limited operation

(2) resuscitate and stabilize the patient in the ICU

(3) perform one or more subsequent operations to complete the surgical goals


The patient may have an open abdomen with a negative pressure dressing after the initial surgery.


A patient may be a candidate for RSCL if the patient:

(1) has severe sepsis or septic shock

(2) has metabolic acidosis with a serum lactate >= 3 mmol/L

(3) has acidosis with arterial pH <= 7.25

(4) has >= 3 comorbidities

(5) is elderly (>= 70 years)

(6) is male

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