skin closure

• Previous message: skin closure
• Next message: trauma-list Digest, Vol 67, Issue 43
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]

Hello Mike,

 

1. What kind of fascial closure if it comes together without tension:
running or interrupted and what suture?

Nylon loop, running #1.

 

 

2. Any role for retention sutures?

No !!!

 

 

3. Skin closure: when and how - complete closure , place wicks or drains?

When fascia is closed, no drains inside peritoneal cavity (only under skin,
JP#10s, if developed huge flaps for non-tension closure)

 

Mickey.

 

*******************************************************************

Michael Stein MD

Chairman, Israel Trauma Society

Director of Trauma, Attending Surgeon

Department of Surgery,

Rabin Medical Center - Beilinson Hospital,

Petach-Tikva, 49100

ISRAEL

 

E-mail:  <mailto:mshtein at clalit.org.il> mshtein at clalit.org.il (W)

E-Mail: michael at steinmail.net (H)

Tel: (+972) 3-937-7043

Fax: (+972) 3-937-7042

Cell: (+972) 50-763-7752

*******************************************************************

 

  _____  

From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Sise, Mike MD
Sent: Wednesday, February 04, 2009 3:45 PM
To: Trauma &amp; Critical Care mailing list
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

 

  _____  

From: Ruy Cabello-Pasini [mailto:ruycabello at yahoo.com]
Sent: Tue 2/3/2009 8:42 PM
To: Trauma & Critical Care mailing list
Subject: Re: skin closure

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
>
>
>
> Send trauma-list mailing list submissions to
>         trauma-list at trauma.org
>
> To subscribe or unsubscribe via the World Wide Web, visit
>       
> http://list.mistral.net/mailman/listinfo/trauma-list
> or, via email, send a message with subject or body
> 'help' to
>         trauma-list-request at trauma.org
>
> You can reach the person managing the list at
>         trauma-list-owner at trauma.org
>
> When replying, please edit your Subject line so it is more
> specific
> than "Re: Contents of trauma-list digest..."
>
>
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
>
>
>      
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/


     

-------------- next part --------------
A non-text attachment was scrubbed...
Name: winmail.dat
Type: application/ms-tnef
Size: 13858 bytes
Desc: not available
URL: <http://list.mistral.net/pipermail/trauma-list/attachments/20090205/e56dd3d2/attachment.bin>

• Previous message: skin closure
• Next message: trauma-list Digest, Vol 67, Issue 43
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]