J Trauma Acute Care Surg. 2019 Apr 25;Epub ahead of print

# Progress on combat damage control resuscitation/ surgery and its application in the Chinese People's Liberation Army.

Chen S, Yang J, Zhang L, Yang L, Qin H, Liu D, Ye Z, Du W, Zhong X, Zong Z

Damage control resuscitation and damage control surgery (DCR/DCS) has now been developed as a well-established standard of care for severely injured civilian patients worldwide. On the other hand, the application of combat DCR/DCS has saved the lives of thousands of severely injured casualty in several wars during the last two decades. This article describes the great progress on DCR/DCS in the last two decades and its application in the Chinese People's Liberation Army (PLA). The main development of the advanced theories of combat DCR/DCS including the global integration of DCR/DCS, application of remote battlefield DCR, balanced hemostatic resuscitation in combat hospitals and enhancement of en route DCR. There are two key factors that determine the feasibility of combat DCR: one is the availability of resources and supplies to implement the advanced theories of combat DCR/DCS, the other is the availability of qualified personnel who master the skills needed for the implementation of DCR/DCS. In the PLA, the advanced theories of combat DCR/DCS have now been widely accepted, and some of related advanced products such as fresh-frozen plasma, packed red blood cells and platelets have been available in level III medical facilities. In conclusion, great progress in combat DCR/DCS has been achieved in recent years, and the Chinese PLA is keeping good pace with this development, although there is still room for improvement. Study type Review article evel of evidence This is a general review article, does not require a level of evidence.