A 65-Year-Old Man Remains Hospitalized on the Surgical Intensive Care

A 65-year-old man remains hospitalized on the surgical intensive care unit 3 weeks after a small bowel resection secondary to ischemic bowel disease.  The postoperative course was complicated by wound dehiscence and sepsis.  The patient is slowly recovering now but still has an open abdominal wound and a tracheostomy.  He is alert and oriented and has given the physician permission to speak with family members.  The patient's son and daughter are visiting today.  They are both very upset and approach the physician to discuss their concerns.  The daughter says, "My father should be better by now."  The son says, "I can't understand how you allowed him to get an infection.  Aren't there precautions to prevent this from happening?"  They demand that his abdomen be closed immediately and the patient transferred to a different hospital.  Which of the following is the most appropriate response to the patient's family?

A) I can reassure you that your father is receiving the best care and leaving the wound open is medically necessary.
B) I can see you are upset, but leaving the wound open will benefit your father in the long term.
C) I can see you are upset.  We cannot close the wound, but I will arrange to transfer your father if he agrees.
D) I understand it is upsetting to see your father in this condition.  Let me explain his course and the proposed plan.
E) I understand you are upset and have questions.  Let us set up an appointment so we can discuss your concerns in detail.