We appreciate the comments by Dickson and colleagues in their letter to the editor on our published article.
1We 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.
- Khajuria A.
- Geoghegan L.
- Solberg Y.
- et al.
Selective non-operative management for penetrating extremity trauma: a paradigm shift in management?.
J Plast Reconstr Aesthet Surg. 2018; 71: 1239-1244
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Plastic, Reconstructive & Aesthetic Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- 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
Published online: January 14, 2019
Accepted: January 6, 2019
Received: December 30, 2018
DOI of original article: https://doi.org/10.1016/j.bjps.2018.12.054.
© 2019 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.
ScienceDirectAccess this article on ScienceDirect
- 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.