Systematic Review of Medical Optimisation of Polytrauma Patients Undergoing Surgery

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Published: 2026-07-18
DOI: https://doi.org/10.61919/7zp2qc45
Keywords:
Polytrauma; Multiple Trauma; Medical Optimization; Damage-Control Resuscitation; Damage-Control Surgery; Perioperative Care; Surgical Timing; Trauma-Induced Coagulopathy.

Main Article Content

Danesh Gul
Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Jabbar Ghufran Syed
Sohail Trust University Hospital, Jinnah Medical and Dental College, Karachi, Pakistan
Abdul Wasey
Dr Ruth K. M. Pfau Civil Hospital Karachi, Karachi, Pakistan
Saoud Javed
RIMS Trauma Hospital, Karachi, Pakistan
Javed Ahmed Chandio
Indus Hospital and Health Network, Pakistan
Munza Yousuf
Dubai Health, Dubai, United Arab Emirates
Nazish Marvi
University of Sindh, Jamshoro, Pakistan

Abstract

Background: Polytrauma patients undergoing surgery frequently present with hemorrhage, coagulopathy, hypothermia, metabolic disturbance, respiratory compromise, and competing operative priorities. Objective: To synthesize current evidence regarding medical and physiological optimization of adults with polytrauma undergoing surgery. Methods: A mixed-evidence systematic review with narrative synthesis was conducted using PubMed/MEDLINE, Scopus, Embase, Web of Science, the Cochrane Library, and Google Scholar. Evidence published principally from 2021 onward was considered, with clinically relevant landmark publications identified through reference screening. Eligible sources examined resuscitation, operative timing, imaging, anaesthesia, infection prevention, multidisciplinary care, or rehabilitation. Results: Twenty publications were included. The evidence consistently prioritized hemorrhage control, haemostatic resuscitation, correction of coagulopathy and hypothermia, individualized imaging and anaesthetic management, and repeated physiological reassessment. Damage-control strategies were most applicable to unstable patients, whereas early definitive surgery was supported after adequate physiological recovery. Whole-body computed tomography aided injury detection and planning in appropriately selected patients. Evidence for universal operative-readiness thresholds and broad antibiotic prophylaxis remained uncertain. Conclusion: Perioperative optimization in polytrauma should be individualized and physiology-guided rather than based on fixed surgical timelines

Article Details

Issue

Vol. 4 No. 14 (2026): Volume 4, Issue 14 (July 2026)

Section

Review Articles
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

1.
Danesh Gul, Jabbar Ghufran Syed, Abdul Wasey, Saoud Javed, Javed Ahmed Chandio, Munza Yousuf, et al. Systematic Review of Medical Optimisation of Polytrauma Patients Undergoing Surgery. JHWCR [Internet]. 2026 Jul. 18 [cited 2026 Jul. 18];4(14):1-15. Available from: https://www.jhwcr.com/index.php/jhwcr/article/view/1965

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