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Tue Jan 16 20:50:44 GMT 2007

Karim,

Where is the support for 3 doses?  why would you give that versus 1 dose?  If a dirty colon injury only needs 24 hrs (take your pick of drug that covers), why 3 doses in sm. bowel injury.  Is there literature support for this?  

Do you leave skin open after penetrating colon trauma and do a delayed closure?

RD

> Date: Mon, 15 Jan 2007 10:05:19 +0000> From: karimbrohi at gmail.com> To: trauma-list at trauma.org> Subject: Re: small bowel injury> > 1. 3 doses of antibiotics, commencing with the first one pre-op. (Remember> this is for reducing wound infection, not to reduce the incidence of> intra-abdominal abscess).> > 2. Never leave the skin open (no evidence for any GI surgery) unless you> need to leave the whole abdomen open of course.> > Karim> > > On 14/01/07, Roy Danks <roydanks at hotmail.com> wrote:> >> > skin open for small bowel? nah. Don't believe there is any literature> > addressing that. Colon? Definately. Moore in Denver looked at that: very> > beneficial to do delayed skin closure.> >> > RD> >> >> >> > > From: ldresner at gmail.com> Date: Sat, 13 Jan 2007 20:51:49 -0500> To:> > trauma-list at trauma.org> Subject: Re: small bowel injury> > one dose preop.> > none postop- i dont think there is a standard of > care in patients who are> > in shock postop though.> > leave skin open> > lisa d> suny downstate> > On> > Jan 11, 2007, at 10:09 PM, Roy Danks wrote:> > > small bowel? one dose.> > Colon: 24 hrs. I just don't know why, > > with the relative paucity of> > bacteria in the small bowel why more > > than one dose would be needed. If I> > do an elective small bowel > > resection for X disease, I don't give them> > any more than the > > induction antibiotic dose...I guess if you're worried> > about what > > went into the belly with the bullet, that's something else,> > but > > can't remember the last time I saw a staph infection of the belly >> > > after a relatively uncomplicated GSW.> >> >> Date: Thu, 11 Jan 2007> > 14:36:10 -0500> From: jkepros at pol.net> To: > >> trauma-list at trauma.org>> > Subject: Re: small bowel injury> > The > >> EAST guidelines (www.east.org)> > have a pretty clear recommendation > >> of> 24h for that. I believe you are> > correct.> John Kepros MD> > >> Michigan State University> > > Dear List,> >> > I was wondering if > >> you could help settle a friendly discussion I> >> > have with one of > >> my partners...how long to keep antibiotics going> >> > after small > >> bowel injury? I say no more than 24hr. case in point> > 40> > you s/p > >> gsw abdomen, small bowel resection primary anastomosis.> > Any> > > >> literature support would be helpful. Thanks Joe> >> >> > > >>> > ---------------------------------> > Everyone is raving about the > >>> > all-new Yahoo! Mail beta.> > --> > trauma-list : TRAUMA.ORG> > To > >>> > change your settings or unsubscribe visit:> > http:// > >>> > www.trauma.org/traumalist.html> > > > --> trauma-list : > >> TRAUMA.ORG>> > To change your settings or unsubscribe visit:> http:// > >>> > www.trauma.org/traumalist.html> >> > _________________________________________________________________> > Fixing> > up the home? Live Search can help.> >> > http://imagine-windowslive.com/search/kits/default.aspx? > >> > kit=improve&locale=en-US&source=wlmemailtaglinenov06--> > trauma-list :> > TRAUMA.ORG> > To change your settings or unsubscribe visit:> >> > http://www.trauma.org/traumalist.html> > --> trauma-list : TRAUMA.ORG> To> > change your settings or unsubscribe visit:>> > http://www.trauma.org/traumalist.html> > _________________________________________________________________> > Try amazing new 3D maps> > http://maps.live.com/?wip=51--> > trauma-list : TRAUMA.ORG> > To change your settings or unsubscribe visit:> > http://www.trauma.org/traumalist.html> >> --> trauma-list : TRAUMA.ORG> To change your settings or unsubscribe visit:> http://www.trauma.org/traumalist.html
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