to sew or not to sew

[totalbodypain]

Just a quik pole. Who sews the galea in small head lacs with galea injury. I am not talking about degloving/large defects but the run of the mill drunk fall down go boom head lacs. There is the whole hematoma forming bla bla bla but not really any literature that I can find on it one way or the other.

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[GeneralVeers]

Just a quik pole. Who sews the galea in small head lacs with galea injury. I am not talking about degloving/large defects but the run of the mill drunk fall down go boom head lacs. There is the whole hematoma forming bla bla bla but not really any literature that I can find on it one way or the other.

Must be bored in New York, all these posts suddenly.

Everything I've ever read says sew it. Have you found something contradictory?

 

[totalbodypain]

Must be bored in New York, all these posts suddenly.

Everything I've ever read says sew it. Have you found something contradictory?

Slow night on trauma. Some of our attendings (the ebm nazi type) swear up and down that it's not necessary in a non surgical small head lac. I was taught previously to do it. Just looking for some verification.

 

[macdaddy23]

I don't always sew it if it comes together well on its own. Been taught by ER staff to sew it, but same thing with you as far as surgeons. When they sew it they rarely sew the galea.

 

[JackBauERfan]

Just a quik pole. Who sews the galea in small head lacs with galea injury. I am not talking about degloving/large defects but the run of the mill drunk fall down go boom head lacs. There is the whole hematoma forming bla bla bla but not really any literature that I can find on it one way or the other.

a neurosurgeon once told me it should always be sewn. I haven't done one yet though..

 

[BKN]

Just a quik pole. Who sews the galea in small head lacs with galea injury. I am not talking about degloving/large defects but the run of the mill drunk fall down go boom head lacs. There is the whole hematoma forming bla bla bla but not really any literature that I can find on it one way or the other.

If the wound gapes, then a significant cut in the galea exists, as it supplies the support of the scalp. Close it. If the wound does not gape, then it's not important to close it separately.

BKN EBM nazi

p.s. to Jack: Your neurosurgeon was probably thinking of Harvey Cushing, who basically invented neurosurgery. He had what was said to be the lowest operative infection rate of any NS up into the 80s. And he operated before antibiotics. Anyway, he was asked about his good results by a science writer. He said "Tell them I close the galea seprately."

I'm afraid my head is stuffed with Hopkins lore that I can't get rid of.