Harvin JA, Sharpe JP, Croce MA, et al. - Researchers sought to assess how damage control laparotomy (DCL) influence major abdominal complications and lengths of stay in patients for whom surgical equipoise exists for DCL and definitive laparotomy (DEF). For safely decreasing the use of DCL, six US Level I trauma centers performed a yearlong, prospective, quality improvement project in 2016. From this cohort of patients undergoing emergent trauma laparotomy, researchers prospectively identified those who underwent DCL but were judged by majority faculty vote at each center to have been candidates for potential DEF (pDEF). They matched these pDEF patients 1:1 using propensity scoring to the DEF patients. Among 872 enrolled patients, 639 (73%) had undergone DEF and 209 (24%) had undergone DCL. Of the 209 DCLs, 44 survived 5 days; of these, they matched 39 pDEF patients to 39 DEF patients. Outcomes revealed the similar probability of major abdominal complications but a high probability of fewer hospital-free, intensive care unit-free, and ventilator-free days in correlation with definitive abdominal closure among patients for whom surgeons have equipoise for DCL vs definitive surgery.