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Thu Aug 10 13:07:43 BST 2006

I am not sure what sides are being manufactured here--I also agree with amputation in the absence of meaningful function as I have been saying--just that at this point what function is left is not clear, and may not be evident for awhile.  Besides, with the patient not willing to lose the leg, there is not much choice in the matter, is there?
ERF 

-----Original Message-----
From: rgross at harthosp.org
To: trauma-list at trauma.org
Sent: Wed, 9 Aug 2006 7:49 PM
Subject: Re: SGW to Femoral triangle - Synthetic vs "autogenous"

All I can say is that I am keeping awesome company - regardless of which
side of the fence one is sitting!!
I am sure that you are gonna let us know what happens to this poor
fellow......many months down the line.
Be well,
Ron

>>> <kmattox at aol.com> 08/09/06 7:40 PM >>>
Ron.  As of today he has an obturator bypass from iliac to popliteal. 
Swollen leg.  No major venous out put.     I suggested to team the leg
is going to be non functional.   The pts doctor is convienced the
surgeons and rehab can have a good functional result.   You and I are on
the same side against Frykberg and the patients doctors. 

K. 
Sent via BlackBerry, return via KMattox at aol.com

-----Original Message-----
From: "Ronald Gross" <Rgross at harthosp.org>
Date: Wed, 09 Aug 2006 19:21:46 
To:<trauma-list at trauma.org>
Subject: Re: SGW to Femoral triangle - Synthetic vs "autogenous"

OK, so now you have me  right where you want me.   ;-)
Again, no pun intended, but I am going to go out on a limb and say that
I would still strongly suggest that the limb be amputated; we have heard
that there is enough to "ambulate ok".  The functional result of
"ambulate OK", and what it is going to take to get there - months and
months of surgery, eventual addition to pain medications, depression,
out of work for months and ever year(s) to attain minimal function
(walking) without the ability to return to gainful employment, and
lastly the high probability of financial ruin - do not seem to be the
right thing to do just to preserve something that will be "OK" to
"ambulate".  Save as much tissue as possible, swing flaps, look to a
(high) AK and get this kid up and moving as soon as possible.
Just my 2 cents.
Ron

>>> <KMATTOX at aol.com> 8/9/2006 7:10 PM >>>

In a message dated 8/9/2006 6:07:50 P.M. Central Standard Time,  
Rgross at harthosp.org writes:

I STILL  have not heard from Ken exactly what has been left with
respect to the  gentleman's thigh musculature, and exactly what sort
of
functional outcome  the physiatrists are predicting with best case
scenario muscle mass they  are going to have to work 

Enough muscle to work leg.   Rehab people think they can work  with him
to 
ambulate ok with existing nerves and muscles.  

k
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SGW to Femoral triangle - Synthetic vs "autogenous"