Abbreviated laparotomy (damage control) in emergency general surgery: indications, risks and resource-based applications in the South African context

Abstract

“Damage-control” surgery originated in trauma care, emphasising expeditious control of haemorrhage and contamination to avert physiological collapse. This concept has extended into emergency general surgery (EGS) for conditions such as peritonitis, bowel ischaemia, and abdominal catastrophes. Mortality in EGS may reach up to 17% in affluent settings. The precise role of abbreviated laparotomy remains ill-defined, especially in resource-diverse environments such as South Africa. Controversies persist regarding its timing and technique – particularly decisions around deferred versus immediate bowel reconstruction and the choice of temporary abdominal closure method – highlighting the need for context-specific guidance.^1,2