Re: Catgut
From: Efrain Ramirez (eramirezt@coqui.net)
Mon Aug 8 09:57:32 2005
I also use plain for Pomeroy's -- I don't Vicryl is a good choice for it
unless one is doing Parkland...
>At Mon, 8 Aug 2005, Charlie Chambers wrote:
>
>Yep, plain gut for Pomeroy's. Any modification has merely decreased the
>efficacy, such as other suture materials, cautery of the cut ends, etc.
>
>************************************************************************
>****
>************************************************************************
>
>--
>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
>************************************************************************
>*****
>************************************************************************
>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>
>
--
"Character may be manifested in the great moments, but it is made in the
small ones."
- Phillip Brooks
~walt whitman~
