Damage control surgery (DCS) is employed in trauma cases when a patient is physiologically unstable and cannot tolerate prolonged operative procedures required for definitive injury repair. The goal is to quickly control sources of bleeding and contamination, followed by resuscitation and re-exploration later.

Indications for Damage Control Surgery

Several factors indicate the need for DCS, often summarized as the "lethal triad" of trauma:

• Hypothermia: Core body temperature below a critical threshold (e.g., $< 36$ °C).
• Acidosis: Severe metabolic acidosis, often indicated by a low pH (e.g., $< 7.32$).
• Coagulopathy: Impaired blood clotting ability, leading to excessive bleeding.

Rationale for Coagulopathy

While low blood pressure (e.g., $< 100$ mm Hg) signifies shock and hypothermia and acidosis are critical components of the lethal triad, coagulopathy is a particularly strong indication for immediate damage control.

Coagulopathy directly compromises the body's ability to achieve haemostasis (stop bleeding). Proceeding with extensive surgical repair in a patient who cannot clot effectively leads to uncontrolled haemorrhage, making the situation rapidly worse and increasing mortality. Therefore, identifying and managing coagulopathy promptly is crucial, often necessitating limiting the initial surgery to essential life-saving measures.