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: diaphragmatic repair

William Bromberg brombwi1 at memorialhealth.com
Fri Aug 28 22:14:43 BST 2015

I cannot argue with anything you said here. I have not seen the repair breakdown because of infection but certainly agree with the potential increased risk theoretically. I really do just love how it ties and use it essentially for nothing else.

William J. Bromberg, MD, FACS
Sent from my iPhone

> On Aug 28, 2015, at 16:54, Errington Thompson <errington at erringtonthompson.com> wrote:
> I think that many people were taught this and I don't think that there is any evidence to support the practice. I have looked and I haven't been able to find anything. 
> BTW, I guess I should add that I haven't used Ethibond suture in over 20 years. A braided permanent suture seems to always be a bad idea. It seems to be a focus for infection. I know that vast majority of things that are sutured with Ethibond don't form granulomas or get infected, I know that some do. So I stay away from that suture. (I must add, I love the way it feels and handles.)
> Errington C. Thompson, MD
> Director of Trauma Services
> Marshall University
>> On Aug 28, 2015, at 13:29, Rwolfer <rwolfer at aol.com> wrote:
>> In my thoracic fellowship i was taught either 0 or number 1 ethibond horizontal mattress or fig 8 interrupted big bites.   Prolene will work as well 
>> Its a " busy" moving muscle need sturdy repair
>> Rw 
>> Sent from my iPhone so I can reply quickly so please forgive any errors
>>> On Aug 28, 2015, at 9:23 AM, Stuke, Lance E. <lstuke at lsuhsc.edu> wrote:
>>> I agree. Permanent suture. I prefer 0-Ethibon, either interrupted or horizontal mattress. If the resident prefers Prolene then I'm ok with that as well.
>>> Lance
>>> Lance Stuke, MD, MPH, FACS
>>> Associate Program Director
>>> LSU Department of Surgery
>>> PHTLS - Associate Medical Director
>>> New Orleans, LA
>>> ________________________________________
>>> From: trauma-list-bounces at trauma.org [trauma-list-bounces at trauma.org] on behalf of William Bromberg [brombwi1 at memorialhealth.com]
>>> Sent: Friday, August 28, 2015 7:15 AM
>>> To: trauma-list at trauma.org
>>> Subject: =?utf-8?B?UmU6IDogZGlhcGhyYWdtYXRpYyByZXBhaXI===?>>> 
>>> 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
>>>> ------------------------------
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