Introduction: Trauma and Traumatic injuries account for about 38% of the weight of surgical diseases and affect in most cases, young people. [1] In the USA trauma ranked fifth as the cause of death throughout the population and is the leading cause of death at age < 44 years.

The majority of preventable hospital deaths from trauma are due to uncontrollable bleeding and the result of the development of the "Lethal Triad" [2].

The technique of Damage control surgery (DCS) has been continuously developing during the treatment of trauma civilians and military during the wars of Napoleon, this technique is closely related to the history of military medicine [3].

The concept of Staged Laparotomy is to help stop the bleeding primary was described in 1908 by Pringle [6]. Halsted & Schroeder individually reported on their success in stopping the bleeding in trauma heparin through its packaging. In 1913 Halsted technique described packaging modifications liver (PH) [6].

The origin of DC was in World War II, which was described by the US Navy as a strategy to salvage the "Vessels Damaged" [8, 9], which consisted of a method to avoid repairing the final immediate injuries to the big vessels and focus only on the preservation of what was needed, restoring the ship [the patient (Pt)] in the secure "harbor" (while maintaining without permeability of water and motor power) to do after in the second stage any definitive repairs.

DCS is defined as the initial fast control of bleeding and contamination. He recommended temporizing patients with abdominal packing and temporary closure to allow restoration of normal physiology prior to returning to the operating room for definitive repair. 

Our goal is to provide a scheme DCS, its indications

Its core concepts are relatively uncomplicated and simple in nature and incorporate.

1-    To appropriate identification of the patient who is in need of following this model;

2-    To realize as soon as possible the initial surgical procedure to the minimum necessary operation;

3-    To permit the aggressive and focused resuscitation in the intensive care unit;

4-    To perform the definitive care only once the patient is optimized to tolerate the procedure.

To illustrate theoretical data we have described the case report with a gunshot wound and discussion of management tactics step by step at all levels of his treatment

Keywords; Lethal triad, abdominal trauma, surgical control of damages, Laparotomy, hypothermia, metabolic acidosis….