Re: Catgut
From: Bernard Cristalli (bcrist@club-internet.fr)
Mon Aug 8 03:14:57 2005
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I use permanent suture.
Would you use Vicryl clips to perform a LT?
BC
Elrod Darryl G MAJ 48 MDOS/SGOBO a écrit :
> Why is it gambling? I thought the idea was to have the suture
> dissolve quickly so the tubes fell apart faster. (or so its told in
> residency)
>
> What do you use for Parkland or Pomeroy tubals?
>
> Glen
>
> ------------------------------------------------------------------------
> ----------------------------------------------------------------------->
> -----------------------------------------------------------------------> *From:* ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] *On Behalf Of
> *Bernard Cristalli
> *Sent:* Monday, August 08, 2005 7:59 AM
> *To:* Multiple recipients of list OB-GYN-L
> *Subject:* Re: Catgut
>
> That's gambling.
> What you want is temporary TL?
> BC
>
> Elrod Darryl G MAJ 48 MDOS/SGOBO a écrit :
>
> I only use plain gut for postpartum or c-section tubal ligations. I
> can't think of any place else it would benefit.
>
> Glen
>
> ------------------------------------------------------------------------
> ----------------------------------------------------------------------->
> -----------------------------------------------------------------------> *From:* ob-gyn-l@obgyn.net <mailto:ob-gyn-l@obgyn.net>
> [mailto:ob-gyn-l@obgyn.net <mailto:ob-gyn-l@obgyn.net>] *On Behalf Of
> *Henry Gregor
> *Sent:* Friday, August 05, 2005 8:38 PM
> *To:* Multiple recipients of list OB-GYN-L
> *Subject:* Catgut
>
> Good - very good - observations by Sam. Prompts the additional
> question of is there a desirable time/place/procedure in any surgery
> for which catgut would be a preferred suture? Probably not, I suspect
> but all thoughts welcome.
>
> Hank Gregor
>
> */"Atkinson, Samuel M" <ATKINSONS@mail.ecu.edu>
> <mailto:ATKINSONS@mail.ecu.edu>/* wrote:
>
> You will find the complete reference on the subject in the August
> issue of Obstetrics and Gynecology (The Green Journal on page 275.)
>
> Reference 6 is the article by Tulandi et al from Montreal
> published in 1988 in AJOG stated that there were more adhesions
> when the peritoneum was closed. In a recent publication letter to
> the editor they again referenced their article which, evidently
> very few people ever read. NO WONDER . They closed the
> peritoneum with PLAIN CATGUT-the most inflammatory suture one can
> use. To quote Michelle Duchinski in TeLinde "...disadvantages
> include intense inflammatory scarring ." "Catgut should not be
> routinely used in gynecologic surgery. Indeed there remains little
> indication for the use of catgut in any gynecologic surgical
> procedure." P 232, seventh edition. No wonder they found more
> adhesions in reperitonealized patients. Two horrible wrongs do
> not equal a right. At last, a level II data paper putting an end
> to this BS.
>
> I suspect our other subscriber who entered the bladder -when she
> looks up the previous OP note-will find that the peritoneum was
> not closed-thus the bladder was adherent to the ant abdominal wall
> and no way could one avoid a bladder entry.
>
> By using a monofilament, poly gycolic fine suture and not pulling
> the peritoneum up tight into a water tight seal, as many of us
> were taught in the dark ages, there will be significantly less
> adhesions than if one leaves the peritoneum open. Loosely
> approximate with non braided polyglycolic suture.
>
> Sam Atkinson
>
> ------------------------------------------------------------------------
> ------------------------------------------------------------------->
> -------------------------------------------------------------------> *From:* ob-gyn-l@obgyn.net <mailto:ob-gyn-l@obgyn.net>
> [mailto:ob-gyn-l@obgyn.net <mailto:ob-gyn-l@obgyn.net>] *On Behalf
> Of *Julio Arellano
> *Sent:* Monday, August 01, 2005 10:39 PM
> *To:* Multiple recipients of list OB-GYN-L
> *Subject:* New paper - Peritoneum closure
>
> Dear colleagues:
>
> A new outlook on parietal peritoneum closure in c-section:
>
> http://www.pslgroup.com/dg/251a56.htm
>
> I'd like to know your opinion on this matter (here, in my
> country, we still discuss about it).
>
> Julio C. Arellano
>
> La Plata. Buenos Aires.
>
> Argentina.
>
> arellano@netverk.com.ar <mailto:arellano@netverk.com.ar>
>
> "Good judgment comes from experience, and often experience comes
> from bad judgment."
> Rita Mae Brown
>
>
>
>
>
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