trauma-list Digest, Vol 47, Issue 8

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Newton

My only critique of your post: Never use Chromic on the heart or blood vessels. Skin stapler - yes. If you want to suture the heart it MUST be a non-absorbable suture.

Chromic catgut really has only two uses today (if you still get it - it is banned in Europe!): Haemostasis for circumcision apposistion and deep tisssue sutures in an ED closure of wounds deeper than the skin on the limbs. Mostly should be replaced by Vicryl or PDS as suture of choice anyhow!

Tim
Dr T C Hardcastle
M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU)
ATLS  instructor and DSTC Cape Town Course Director
Intern program Coordinator: Surgery
M.Med (Emergency Medicine) Executive Committee member
Clinical Head (Director): Diana Princess of Wales Trauma Unit
Division of Surgery (General) Room 4064
Department of Surgical Sciences
Tygerberg Hospital / University of Stellenbosch
PO Box 19063
Tygerberg 7505
Western Cape
South Africa
e-mail: tch at sun.ac.za
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Office: +27219389281 or 4911 pager 0302



-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]On Behalf Of djinmori.alp
Sent: Thursday, May 03, 2007 4:18 PM
To: trauma-list
Subject: Re:trauma-list Digest, Vol 47, Issue 8


Thoracotomy
In the ED environment you can started anteriorly at left side. If is necessary you can go to the right side in
very few seconds.
We still perform balloon tamponade but it depends on the situation, I mean, you can suture directly with
chromade catgut 2-0 initially and then treat definitively in the OR, and when disposable you can use skin
stapler. etc...
 
MD, Newton Djin Mori
Surgical Emergency Service
Hospital das Clínicas
University of São Paulo School of Medicine
djinmori at terra.com.br

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