**10. Conclusion**

Immediate resuscitation and DCS play a critical role in the outcomes of trauma patients in general, and particularly in those with severe liver injuries where the exsanguination of large amounts of blood is common. The decrease in the time from the scene to hospital and taking, the implementation of massive transfusion protocols, and the improvements in the approaches to control bleeding and contamination intraoperatively by leaving major resections for a later phase have revolutionized the outcomes after liver trauma over the past decades. The advents of pre-hospital care are awaited to change the need for DCS in the future.

**47**

**Author details**

of Thessaloniki, Thessaloniki, Greece

provided the original work is properly cited.

\*Address all correspondence to: tsoulfasg@gmail.com

Ioannis A. Ziogas1†, Ioannis Katsaros2† and Georgios Tsoulfas3

Surgery, Vanderbilt University Medical Center, Nashville, TN, USA

2 Department of Surgery, Metaxa Cancer Hospital, Piraeus, Greece

† Both authors have contributed equally and share first co-authorship.

1 Division of Hepatobiliary Surgery and Liver Transplantation, Department of

3 First Department of Surgery, Papageorgiou General Hospital, Aristotle University

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

\*

*Damage Control Surgery for Liver Trauma DOI: http://dx.doi.org/10.5772/intechopen.94109* *Damage Control Surgery for Liver Trauma DOI: http://dx.doi.org/10.5772/intechopen.94109*

*Trauma and Emergency Surgery - The Role of Damage Control Surgery*

of infection. Other abdominal closure alternatives should be considered if this is not possible. This will lead to a large ventral hernia that will require repair at some future

Immediate resuscitation and DCS play a critical role in the outcomes of trauma patients in general, and particularly in those with severe liver injuries where the exsanguination of large amounts of blood is common. The decrease in the time from the scene to hospital and taking, the implementation of massive transfusion protocols, and the improvements in the approaches to control bleeding and contamination intraoperatively by leaving major resections for a later phase have revolutionized the outcomes after liver trauma over the past decades. The advents of pre-hospital care are

**46**

time point [30].

**Figure 3.**

**10. Conclusion**

awaited to change the need for DCS in the future.

*Surgical management of severe liver injury with active bleeding.*
