Perioperative management of bleeding in trauma patients: a comprehensive review and analysis

Background: Rapid control and correction of bleeding are critical for reducing mortality and improving outcomes in trauma patients. Given the burden of trauma-induced hemorrhagic shock, a comprehensive evaluation of current bleeding management strategies is essential. This review aimed to assess contemporary approaches to perioperative bleeding management in adult trauma patients. Methods: A systematic literature search was conducted across PubMed, HINARI, Google Scholar, and the Cochrane Library using predefined keywords. Studies addressing bleeding management in adult trauma patients were included. Duplicate records were removed using EndNote software, and study selection was performed using a standardized appraisal checklist. The review was conducted and reported in accordance with the PRISMA 2020 guidelines. Results: The initial search identified 49 151 records. After removal of duplicates and initial screening, 17 409 articles underwent title and abstract review, of which 16 409 were excluded. In total, 1000 full-text articles were assessed for eligibility, with 880 excluded due to ineligibility or overlapping objectives. Of the remaining 120 articles, 74 were excluded because full-text access was unavailable. Ultimately, 46 studies met the inclusion criteria and were included in the final analysis. Conclusions: Early and effective control of bleeding remains a cornerstone of trauma care and is strongly associated with improved survival and clinical outcomes in adult trauma patients.