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: diaphragmatic repair

Errington Thompson errington at erringtonthompson.com
Fri Aug 28 16:20:18 BST 2015


Here's what I don't understand, the diaphragm is a muscle. The muscle in the arm I use vicryl. The muscle in the leg I use vicryl. The only muscle that I don't use vicryl on is the heart. I have used vicryl on the diaphragm for years. As far as I know it has held up well. 

I just feel that there is a lot of mystery surrounding diaphragmatic repairs without any good reason for the mystery. Interrupted horizontal mattress sutures to repair a hole in the diaphragm is nice but unnecessary for most injuries in my opinion.  

Errington C. Thompson, MD
Director of Trauma Services
Marshall University

> On Aug 28, 2015, at 09:22, Kenneth Mattox <kmattox at aol.com> wrote:
> 
> Diaphragm tears and incisions have been repaired successfully w many different sutures, both running and interrupted. Reinforcement w mesh has not been established as being necessary.  
> 
> Sent from my iPhone
> 
>> On Aug 28, 2015, at 7:15 AM, William Bromberg <brombwi1 at memorialhealth.com> wrote:
>> 
>> I figure permanent suture would be the best because I have no idea how strongly the diaphragm heels. I personally use interrupted Ethibond because  I like the way it ties down deep in the hole.
>> 
>> Data? We don't need no stinking data.
>> 
>> William J. Bromberg, MD, FACS
>> Sent from my iPhone
>> 
>>> On Aug 28, 2015, at 07:28, rm khattar <dr_rm_khattar at yahoo.co.in> wrote:
>>> 
>>> 
>>> I have repaired diapragm with 2-0 prolene.Why because it is a dynamic muscle tissue.I f I have to do it tomorrow I will re-enforce with coated prolene mesh.
>>> 
>>> R.M.Khattar
>>> 
>>> 
>>> ------------------------------
>>>> On Fri 28 Aug, 2015 4:28 PM IST Errington Thompson wrote:
>>>> 
>>>> When repairing the diaphragm what suture do you use and why? When I was reading the Trauma textbook, there was a rather long discussion about what suture to use and how to repair the diaphragm but there was no data (that I saw) to support it. 
>>>> 
>>>> Errington C. Thompson, MD
>>>> Director of Trauma Services
>>>> Marshall University
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