Patients who have suffered trauma can often have severe physiologic derangements, including metabolic acidosis, coagulopathy, and hypothermia. These occur as a direct result of hemorrhage and collectively represent the lethal triad of trauma. Each aspect of the lethal triad potentiates worsening of the other two, leading to a cycle of rapid physiologic deterioration. Prolonged operative times, for a variety of reasons, can exacerbate these derangements and increase mortality (Rotondo et al., J Trauma 35:375–382, 1993; Schreiber, Crit Care Clin 20:101–118, 2004). This concept has led to an emphasis of rapidly leaving the operating room in favor of rewarming and correction of coagulopathy and acidosis in the intensive care setting after immediate threats to life (bleeding) and temporary control of contamination (enteric spillage) have been at least temporarily addressed. This strategy is known as damage control surgery.