title: The impact of surgical timing and intervention on outcome in traumatized dogs and cats.
abstract: OBJECTIVE
  To review the relevant human and veterinary literature regarding the timing of surgical intervention for trauma patients and the impact on outcome.
  
  
  METHODS
  Original research, clinical studies, and review articles with no date restrictions from both human and veterinary literature.
  
  
  RESULTS
  Despite extensive research into the ideal timing of surgical intervention for human trauma victims, debate is ongoing and views are still evolving. Prior to the 1970s, the standard of care consisted of delayed surgical treatment, as these patients were considered too ill to undergo surgery. Beginning in the 1970s, and continuing for nearly 2 decades, early definitive surgical treatment was recommended. The most recent evolution of human trauma management incorporates the concept of damage control surgery, which acknowledges the importance of early skeletal stabilization or laparotomy for reducing morbidity while attempting to avoid complications such as acute respiratory distress syndrome or multiple organ dysfunction syndrome.
  
  
  RESULTS
  Despite a relatively large amount of literature available regarding veterinary trauma, no evidence exists to provide the clinician guidance as to the ideal timing of surgery for trauma patients. With the exception of diaphragmatic hernia, no studies were identified that attempted to evaluate this variable.
  
  
  CONCLUSIONS
  Veterinary-specific studies are needed to evaluate the impact of surgical timing on outcome following trauma. The information that can be obtained from studies in this area can improve veterinary trauma care and may be used as models for human trauma care through translational applications.
authors.affiliation: Departments of Critical Care, VCA West Los Angeles Animal Hospital, Los Angeles, CA, 90025.
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Peterson
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Buote
authors.forename: James W
authors.initials: JW
authors.lastname: Barr
mesh_terms: D000818:Animals; D002415:Cats / Q000293:injuries*; D004285:Dogs / Q000293:injuries*; D006549:Hernia, Diaphragmatic, Traumatic / Q000601:surgery / Q000662:veterinary*; D006801:Humans; D011183:Postoperative Complications; D016019:Survival Analysis; D013997:Time Factors; D014730:Veterinary Medicine; D014947:Wounds and Injuries / Q000601:surgery / Q000662:veterinary*
keywords: damage control surgery; multiple organ failure; trauma; “2-hit theory”