• Reuben He, Victor Kong, Jonathan Ko, Anantha Narayanan, Howard Wain, John Bruce, Grant Laing, Vassil Manchev, Wanda Bekker, and Damian Clarke.
• Department of Surgery, The University of Auckland, Auckland, New Zealand. rhe351@aucklanduni.ac.nz.
• Eur J Trauma Emerg Surg. 2024 Jun 18.

PurposeOver the last three decades, damage control laparotomy (DCL) has become important in the management of abdominal gunshot wounds (GSW). This paper reviews the experience of a single institution over a decade with the use of DCL for GSW of the abdomen.MethodsLongitudinal data (2013-2022) was collected from the Hybrid Electronic Medical Registry database to identify all patients with an abdominal GSW over the study period. The data was stratified based on patients who underwent DCL and those who did not. Descriptive analysis was completed to summarise the raw data. Univariate and multivariate analysis was completed to identify variables associated with undergoing DCL.ResultsThere were 135 patients (32%) who underwent DCL and 290 patients (68%) who did not. Colonic, small bowel, mesenteric, hepatic, pancreatic and intra-abdominal vessel injuries were associated with the need for DCL (P<0.05). In total, 85 of the 135 (63%) patients who underwent DCL required more than one damage control technique. There were 45 (33%) mortalities in the DCL group compared to 16 mortalities (6%) in the non-DCL group (P<0.001).ConclusionOne third of patients who underwent a laparotomy following a gunshot wound to the abdomen had a DCL. The indications for DCL include both physiological criteria and injury patterns. DCL is associated with significant morbidity and mortality. Efforts need to be directed towards refining the indications for DCL in this group of patients to prevent inappropriate application of this potentially lifesaving technique.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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