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Introduction.Gunshot wounds to the head are more common in military settings. Recently, a damage control (DC) approach for the management of these lesions has been used in combat areas. The aim of this study was to evaluate the results of civilian patients with penetrating gunshot wounds to the head, managed with a strategy of early cranial decompression (ECD) as a DC procedure in a university hospital with few resources for intensive care unit (ICU) neuro-monitoring in Colombia. Materials and methods.Fifty-four patients were operated according to the DC strategy (<12 h after injury), over a 4-year period. Variables were analysed and results were evaluated according to the Glasgow Outcome Scale (GOS) at 12 months post injury; a dichotomous variable was established as ‘favourable’ (GOS 4–5) or ‘unfavourable’ (GOS 1–3). A univariate analysis was performed using aχ2test. Results.Forty (74.1%) of the patients survived and 36 (90%) of them had favourable GOS. Factors associated with adverse outcomes were: Injury Severity Score (ISS) greater than 25, bi-hemispheric involvement, intra-cerebral haematoma on the first CT, closed basal cisterns and non-reactive pupils in the emergency room. Conclusion.DC for neurotrauma with ECD is an option to improve survival and favourable neurological outcomes 12 months after injury in patients with penetrating traumatic brain injury treated in a university hospital with few resources for ICU neuro-monitoring. [ABSTRACT FROM PUBLISHER]

Introduction: Severe traumatic brain injury (sTBI) is a disease that generates significant mortality and disability in Latin America, and specifically in Colombia. The purpose of this study was to evaluate the 12-month clinical outcome in patients with sTBI managed with an early cranial decompression (ECD) as the main procedure for damage control (DC) therapy, performed in a University Hospital in Colombia over a 4-year period. Materials and Methods: A database of 106 patients who received the ECD procedure, and were managed according to the strategy for DC in neurotrauma, was analyzed. Variables were evaluated, and the patient outcome was determined according to the Glasgow Outcome Score (GOS) at 12 months postinjury. This was used to generate a dichotomous variable with "favorable" (GOS of 4 or 5) or "unfavorable" (GOS of 1-3) outcomes; analysis of variance was performed with the Chi-square, Wilcoxon-Mann-Whitney and Fisher tests. Results: An overall survival rate of 74.6% was observed for the procedure, At 12 months postsurgery, a favorable clinical outcome (GOS 4-5) was found in 70 patients (66.1%), Unfavorable outcomes in patients were associated with the following factors: Closed trauma, an Injury Severity Score >16, obliterated basal cisterns, subdural hematoma as the main injury seen on the admission computed tomography, and nonreactive pupils observed in the emergency department. Conclusion: Twelve months outcome of patients with sTBI managed with ECD in a neuromonitoring limited resource University Hospital in Colombia shows an important survival rate with favorable clinical outcome measure with GOS. [ABSTRACT FROM AUTHOR]