skin closure

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What works for us:

1. Running, looping prolene fascial sutures that can be left loose.
Can be gradually pulled to tighten over a period of days.

2. Tension sutures act like bowstrings inside the abdomen and can cut
into bowel (seen it happen once).

3. Skin closure as soon as fascial closure is achieved (once prolene
has been pulled taut).

Regards
S Muzammil, FRCS
Combined Military Hospital
Pano Aqil, Pakistan

From: "Sise, Mike MD" <Sise.Mike at scrippshealth.org>
To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Date: Wed, 4 Feb 2009 05:44:44 -0800
Subject: RE: skin closure
Regarding abdominal wound management following damage control: please
consider and answer 3 questions in stable patient with non
contaminated abdomen post op 24 to 72 hrs at first take back:

1. What kind of fascial closure if it comes together without tension:
running or interrupted and what suture?
2. Any role for retention sutures?
3. Skin closure: when and how - complete closure , place wicks or drains?

Mike Sise
San Diego

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