Description
In this presentation, Daren Forward discusses the evolution of surgical approaches in treating orthopedic injuries, particularly focusing on the comparison between early total care and damage control strategies. He explains the historical context of these concepts, tracing their origins back over 20 years ago to a general surgeon at Shock Trauma in Baltimore. The idea of damage control was aimed at limiting further injury—akin to managing damage on a naval vessel. Daren reflects on the initial controversies that arose with the introduction of early total care, particularly from PAPI's studies showing high rates of ARDS associated with this approach.
Daren highlights inconsistencies in outcomes from different healthcare systems, particularly contrasting American and German methods of resuscitation and treatment that led to varied ARDS rates among patients. He emphasizes the importance of high-quality, thoughtful resuscitation without rushing, using appropriate markers to assess and guide treatment effectively. Through the example of a recent patient who sustained severe injuries, he illustrates the successful implementation of a structured yet flexible approach to care, demonstrating that careful timing and quality of resuscitation significantly influence patient outcomes. Ultimately, Daren advocates for a tailored approach to care that prioritizes patient safety and suits individual circumstances.