[Must all diaphragmatic penetrating wounds be sutured?]

Wounds to the abdominal-thoracic region are associated with diaphragm wounds in up to 48% of cases. Lesions secondary to diaphragm trauma are present in the majority of cases, facilitating the diagnosis of diaphragm lesion and subsequent surgical management. However, diaphragm lesions are isolated in 8 to 10% of cases and because they present few or no symptoms may be overlooked. In such situations, can the diaphragm be treated conservatively without suturing? Based on experiments in animals and a review of the literature, we concluded there is currently insufficient evidence to affirm that diaphragm injuries require no suturing.