trauma-list Digest, Vol 67, Issue 43

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Surely, in a clean wound (or even a dirty wound after debridement/washout
etc)  one is better to give the patient a chance of a single-staged closure.
One would anticipitate less incidence of infection requiring skin to be
opened than what would be prevented by leaving skin open. Staples are easily
removed in any case.

I would love to hear the  rationale for leaving the skin open.

Kind regards,

Brad Morris
Surgical Registrar
Australia

On Tue, Feb 3, 2009 at 2:39 PM, Sise, Mike MD
<Sise.Mike at scrippshealth.org>wrote:

> To all trauma-listers, a question from one of my partners:
>
> You have a damage control closure with a vac closure after a laparotomy for
> trauma without bowel injury (ie just spleen or liver, mesentery, whatever) -
> you take back in 24 to 48 hours and are able to close the fascia.  What do
> you do with the skin?  Leave open or staple closed?
>
> We're having a debate over this in our group. Older surgeons pack skin and
> subQ open, younger surgeons frequently close skin.
>
> Mike Sise
> San Diego
>
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> Subject: trauma-list Digest, Vol 67, Issue 43
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