Damage control surgery in large-scale combat operations: still a life-saving strategy or a bridge to nowhere?

Damage Control Surgery (DCS), originally developed to stabilize critically injured trauma patients, was widely adopted during the Global War on Terror, supported by rapid evacuation and advanced medical infrastructure. Future large-scale combat operations will likely severely disrupt this model due to contested airspace and delayed transport. Patients who have undergone DCS may then be stuck without access to definitive care, overwhelming facilities with limited critical care capacity. A more nuanced context-driven approach to surgical decision-making and embracing a strategy of definitive repair for carefully selected patients could potentially help alleviate the expected challenges we will face in future resource-constrained environments.