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Re: Single Layer vs Double Layer Uterine Closure From: Bernard Cristalli (bcrist@club-internet.fr) Sun Nov 9 15:47:15 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DoctorJoe@aol.com: "Re: Single Layer vs Double Layer Uterine Closure" Previous message: Dr. Bülent Potur: "Re: Single Layer vs Double Layer Uterine Closure" In reply to: Dr. Bülent Potur: "Re: Single Layer vs Double Layer Uterine Closure" Next in thread: Efrain Ramirez: "Re: Single Layer vs Double Layer Uterine Closure" Reply: Efrain Ramirez: "Re: Single Layer vs Double Layer Uterine Closure" Reply: Richard Chudacoff, MD: "Re: Single Layer vs Double Layer Uterine Closure" skin: bistouri Horizontal incision to the fascia, open it horizontally on 1 inch in the middle I use a surgical towel to push the fat laterally (1/2 a second each). the fascia is teared open with two fingers the midline is opened with 2 fingers pulled apart cranially and caudally. 1 scissors cut on the peritoneum and it's opened with 2 fingers no opening of the visceral peritoneum the uterus is opened like the fascia the kid is taken out, and so the placenta the uterus is exteriorised On layer closure with a continuous suture of #1 Vicryl® I put a figure of 8 on my side and begin the suture on the other side (figure of 8) to end on the first knot on my side no closure of the peritoneum closure of the fascia with a 2/0 Vicryl in the same way as the uterus (no fig of 8 knots). staples for the skin Bulent Potur wrote > For example do you really close the skin with > only three separated stiches? -- a bit more > Do you open nearly the whole fascia with > caudal and cranial traction? -- yes > Do you use no 1 polyglactin or no 1 chromic > for one layer uterine closure? -- yes > Do you believe that the absorbtion time > of polyglactin is so long that it can protrude through vagina several > months after the operation? -- never seen that in 20 years since my residency > Can you easily perform the operation in > repeat cases or do yo have to rely on scissors more on them? -- in repeat cases, according to adhesions, scissors are more useful, indeed. -- Bernard Cristalli MD AMACOG AIHP - ACCA Paris France http://www.CliniquedelEssonne.fr http://www.obgyn.net/corresp/cristalli.htm http://www.gyneweb.fr '64 Mk2 3.8 > De : bpotur@ttnet.net.tr (Dr. Bülent Potur) Next message: DoctorJoe@aol.com: "Re: Single Layer vs Double Layer Uterine Closure" Previous message: Dr. Bülent Potur: "Re: Single Layer vs Double Layer Uterine Closure" In reply to: Dr. Bülent Potur: "Re: Single Layer vs Double Layer Uterine Closure" Next in thread: Efrain Ramirez: "Re: Single Layer vs Double Layer Uterine Closure" Reply: Efrain Ramirez: "Re: Single Layer vs Double Layer Uterine Closure" Reply: Richard Chudacoff, MD: "Re: Single Layer vs Double Layer Uterine Closure"

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