Re: Catgut
From: Bernard Cristalli (bcrist@club-internet.fr)
Mon Aug 8 11:04:26 2005
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I understand the high rate of failure.
BC
Charlie Chambers a écrit :
> 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
>
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>
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