trauma-list Digest, Vol 67, Issue 43

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Mike 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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Dear Mike

I close skin - as do most South African surgeons to my knowledge; the idea
of leaving skin open is a very American thing, certainly never advocated
in this country and to my knowledge not in the UK or Australia either.

Tim
Dr T C Hardcastle
M.B., Ch.B. (Stell); M. Med. (Chir) (Stell); FCS (SA)
Principal Specialist Trauma Surgeon /
Honorary Lecturer UKZN Dept Surgery
Deputy Director - IALCH Trauma Service
Durban - South Africa

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