skin closure

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I also always close the skin, if patient has a thick subcutaneous layer, I use a penrose drain over the aponeurosis and through the same incision, anybody?
Ruy Cabello-Pasini, MD
MEXICO  


--- On Wed, 2/4/09, Robert Nitt <robertnitt at yahoo.com> wrote:

> From: Robert Nitt <robertnitt at yahoo.com>
> Subject: Re: trauma-list Digest, Vol 67, Issue 43
> To: "Trauma & Critical Care mailing list" <trauma-list at trauma.org>
> Date: Wednesday, February 4, 2009, 3:35 AM
> Close skin whenever can.  If damage control with extensive
> resuscitation or bowel spillage, pack open and delayed
> closure
> 
>  Kumash Patel, MD, FACS
> Scottsdale Surgical Specialists
> General / Acute Care / Trauma / Critical Care Surgery
> 
> 
> 
> 
> ________________________________
> From: "McSwain, Norman E Jr."
> <nmcswai at tulane.edu>
> To: trauma-list at trauma.org
> Sent: Tuesday, February 3, 2009 5:39:42 AM
> Subject: Re: trauma-list Digest, Vol 67, Issue 43
> 
> 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
> 
> ________________________________
> 
> From: trauma-list-bounces at trauma.org on behalf of
> trauma-list-request at trauma.org
> 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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