• Andres M Rubiano, Miguel Maldonado, Jorge Montenegro, Claudia M Restrepo, Ahsan Ali Khan, Ruy Monteiro, Rodrigo M Faleiro, José N Carreño, Robson Amorim, Wellingson Paiva, Erick Muñoz, Jorge Paranhos, Alvaro Soto, Rocco Armonda, and Jeffrey V Rosenfeld.
• Institute of Neurosciences and Neurosurgery, El Bosque University, Bogotá, Colombia; NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK; INUB MEDITECH Research Group, MEDITECH Foundation, Cali, Colombia; MEDITECH Foundation, Cali Valle, Colombia. Electronic address: andresrubiano@aol.com.
• World Neurosurg. 2019 May 1; 125: e82e93e82-e93.

ObjectiveThe aim of the present review was to describe the evolution of the damage control concept in neurotrauma, including the surgical technique and medical postoperative care, from the lessons learned from civilian and military neurosurgeons who have applied the concept regularly in practice at military hospitals and civilian institutions in areas with limited resources.MethodsThe present narrative review was based on the experience of a group of neurosurgeons who participated in the development of the concept from their practice working in military theaters and low-resources settings with an important burden of blunt and penetrating cranial neurotrauma.ResultsDamage control surgery in neurotrauma has been described as a sequential therapeutic strategy that supports physiological restoration before anatomical repair in patients with critical injuries. The application of the concept has evolved since the early definitions in 1998. Current strategies have been supported by military neurosurgery experience, and the concept has been applied in civilian settings with limited resources.ConclusionDamage control in neurotrauma is a therapeutic option for severe traumatic brain injury management in austere environments. To apply the concept while using an appropriate approach, lessons must be learned from experienced neurosurgeons who use this technique regularly.Copyright © 2019 Elsevier Inc. All rights reserved.

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