Damage Control Laparotomy (DCL) Trial

The purpose of this website is to inform the public of a clinical trial in which they may be enrolled without consent.

About This Research Trial

A laparotomy is an open abdominal surgery typically via midline, vertical incision.  Emergent laparotomy is the most common treatment for patients with life-threatening hemorrhage and intra-abdominal injury, yet very little high-quality data exists to guide clinical decision-making during the procedure.

A damage control laparotomy (DCL) is an abbreviated form of emergent laparotomy in which bleeding is stopped and contamination from the GI tract is stopped.  The abdominal incision is left open with a dressing and the patient transferred to the intensive care unit for resuscitation.  Once the patient is stable they are taken back to the operating room where the surgeon examines and/or repairs the injuries and closes the incision.

DCL was popularized in the 1980s and 1990s following two small, retrospective studies.  The indications for and overall rates of DCL have increased since that time without rigorous studies to determine its effectiveness.  Many retrospective studies have suggested an association between DCL and postoperative complications, however at this point, it is unclear if the severity of patient injury is responsible for this association between DCL and complications.

The proposed benefits of DCL are improved outcomes with a second opportunity to identify injuries that may be missed during the first surgery, improved mortality in bleeding patients, and a decreased incidence of clotting disorders and temperature disturbances.  The proposed disadvantages of DCL are postoperative complications, increased cost, and the need for a second potentially unnecessary operation.

The goal of the DCL Trial is to determine if DCL causes post-operative complications. 

This trial is registered with https://clinicaltrials.gov/.

Thank you for your interest in the UTHealth Damage Control Laparotomy (DCL) Trial.  Please follow the links to the left to see information about emergency research, exception from informed consent, the DCL Trial details, and how to opt out if desired.