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Tue Feb 3 12:39:42 GMT 2009

This "older surgeon" would likely close the skin.

Preferences & principles again...

principle: skin needs to closed sometime. 

Preference - when?.........What is the condition of the wound. It is less than 72 hours; no bowel injury; was the patient overloaded with fluid?; how much pull on the skin to close?.

Typed by the thumbs of 
Norman on his BlackBerry 

Norman McSwain, MD 
Tulane Univ Surgery 
504 988-5111

________________________________

From: trauma-list-bounces at trauma.org 
To: trauma-list at trauma.org 
Sent: Mon Feb 02 22:39:54 2009
Subject: RE: trauma-list Digest, Vol 67, Issue 43 

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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Sent: Tue 1/27/2009 12:35 AM
To: trauma-list at trauma.org
Subject: trauma-list Digest, Vol 67, Issue 43

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trauma-list Digest, Vol 67, Issue 43