--
Richard Chudacoff, MD
The more laws, the less justice.
Marcus Tullius Cicero
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Bernard
Cristalli
Sent: Sunday, November 09, 2003 4:48 PM
To: Multiple recipients of list OB-GYN-L
Subject: 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(r)
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)
