Letter to the Editor regarding – Selective non-operative management for penetrating extremity trauma: A paradigm shift in management

We read with great interest the recently published cohort study by Hettiaratchy et al1 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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