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Fri Feb 29 23:35:20 GMT 2008

I am sure that we all agree that every technique has the capability to be
deadly. What we need to ensure is that we always act in the best interests
of the patient in question. I do perform, and have performed, both
techniques on frequent occasions - so I consider myself impartial enough to
recommend the best technique applicable for each individual patient given
the circumstances. For trauma I truly believe that the open/blunt dissection
technique is best. My method of performing the open/blunt dissection
technique has no difference in patient discomfort compared to the Seldinger
technique - as all patients are well analgesed with local anaesthetic either
way - so this is not an issue. Aruni, I am pleased to say that I do not
consider that one has to be a surgeon to perform the open/blunt dissection
technique. In my opinion, it is all about capability and competence rather
than individual speciality. As Norman quite rightly said, it is all about
outcomes. However the question remains as to whether Seldinger chest drains
do have the same effective outcome as open/blunt dissection chest drains in
trauma. I sincerely believe that they don't.

Matthew

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