Re: Catgut
From: Charlie Chambers (cchamber@gorge.net)
Mon Aug 8 08:49:44 2005
Yep, plain gut for Pomeroy's. Any modification has merely decreased the
efficacy, such as other suture materials, cautery of the cut ends, etc.
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Charlie Chambers
Hood River, OR USA
cchamber@alumni.rice.edu
"...not because I regard fishing as being so terribly
important but because I suspect that so many of the other
concerns of men are equally unimportant-and not nearly
so much fun."
John Voelker
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On Aug 8, 2005, at 4:17 AM, Larry Glazerman wrote:
>
> My understanding is that the original work by Pomeroy used the fact
> that when catgut was used, the two ends of the tube didn’t stay in
> approximation for very long, therefore the risk of fistula was
> decreased. I can’t prove that, but that’s why I remember always using
> catgut for tubals
>
>
>
> Larry R. Glazerman, MD
>
> Ob-Gyn at Trexlertown, PC
>
> 610-402-0161
>
> l.glazerman@rcn.com
>
> <unknown.jpg>
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
> Bernard Cristalli
> Sent: Monday, August 08, 2005 2:59 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] 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> 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] 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
>>
>> "Good judgment comes from experience, and often experience comes
>> from bad judgment."
>> Rita Mae Brown
>>
>>
>> <imstp_emo_es.gif>
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