We appreciate the comments by Dickson and colleagues in their letter to the editor
on our published article.
1
We agree with them that non-operative management is a pragmatic approach for penetrating
trauma and our paper is the first documented attempt to apply this approach to a UK
trauma population. It is inevitable and appropriate that conservative management of
trauma is scrutinized as it is counter to most current plastic surgical doctrine,
though conservative management of other types of trauma is commonplace. Managing trauma
conservatively is a much harder decision to make than managing it operatively. Successful
non-operative management requires more detailed assessment and more extensive experience
than operative management. Our paper was attempting to define our centre's experience
of trying to avoid operations that confer no clinical benefit but just add to the
patient's morbidity.To read this article in full you will need to make a payment
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References
- Selective non-operative management for penetrating extremity trauma: a paradigm shift in management?.J Plast Reconstr Aesthet Surg. 2018; 71: 1239-1244
- Treatment of penetrating trauma of the extremities: ten years' experience at a Dutch level 1 trauma center.Scand J Trauma Resusc Emerg Med. 2013; 21: 2
Article info
Publication history
Published online: January 14, 2019
Accepted:
January 6,
2019
Received:
December 30,
2018
Footnotes
DOI of original article: https://doi.org/10.1016/j.bjps.2018.12.054.
Identification
Copyright
© 2019 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Letter to the editor regarding: Selective non-operative management for penetrating extremity trauma: A paradigm shift in managementJournal of Plastic, Reconstructive & Aesthetic SurgeryVol. 72Issue 4
- PreviewWe read with great interest the recently published cohort study by Khajuria et al.1 comparing penetrating extremity injury examination results to operative findings. The increasing rate of crime involving a knife or sharp object2 is of concern to all trauma surgeons, and a great pressure to develop safe and effective clinical pathways for penetrating trauma. We agree with the authors that more pragmatic methods may be appropriate to treat these injuries, but question the author's assertion that their data has shown selective non-operative management to be a safe alternative to surgical exploration.
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