Re: two week check up WAS staples at C/S

From: Henry Gregor (henrygregor@yahoo.com)
Tue Aug 1 10:46:40 2006


Serves well to meet the needs of the adage "No one cares what you know, until they know that you care"...so, unencumbered by data, the two week visit probably serves those needs well enough to make it worthwhile. So, I wouldn't feel it scientifically discreditable for anyone to use the two week visit routine.

Hank

ainsron <ainsron@sbcglobal.net> wrote: You’re right, there is nothing magical about two weeks. It’s primarily to make sure they are progressing normally, starting to drive, off pain meds, no signs of a seroma, etc. I just have always had my postop patients and complicated postpartum patients come in for a checkup at two weeks, “it’s the way I was taught,” unencumbered by data.

Ronald E. Ainsworth, MD, FACOG

-----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Elrod, Darryl G Maj 48 MDOS/SGOBO Sent: Tuesday, August 01, 2006 12:57 AM To: Multiple recipients of list OB-GYN-L Subject: Re: two week check up WAS staples at C/S

I’m curious why you do a two week check on c-sections. It has been my experience that if they make it to two weeks without a wound problem, they will be fine by that point. Finally, we just collectively decided that it was a waste of their time and my time to have them come in to look at a perfectly normal incision.

I also tell patients to remove the steristrips at 7-10 days but for some reason the only thing most of them remember is the nurse telling them to leave them in place until they fall off on their own. It has been like pulling teeth to get the nurses not to tell them to do this and go with the 7-10 days.

Glen

//SIGNED// D. Glen Elrod, Maj., USAF, MC Obstetrician/Gynecologist Chief of Obstetrics 48 MDOS/SGOBO RAF Lakenheath, England

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From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Ronald Ainsworth --------------------------------- Sent: Tuesday, August 01, 2006 6:31 AM

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To: Multiple recipients of list OB-GYN-L
Subject: Re: staples at C/S

I've always put them on at the time of discharge, usually third day. If the patient goes home on the second day, I usually have them come in to the office to remove the staples on the fourth or fifth day and then place steri-strips. I always like to use skin-prep to help them adhere better. Skin-prep is basically a stoma adhesive, for those that don't use it. I tell them to remove the steri-strips when they start lifting up in 7-10 days, or I remove them when they come in at their two week checkup. I prefer sutures on the obese patient, either subcuticular or interupted mattress sutures, as I can leave them in longer without getting a significant inflammatory response.

"Garry E. Siegel, M.D." <garrys@mindspring.com> wrote: Dan and others:

I've always been a bit reluctant to remove staples before 3 days, unencumbered by data. I've looked a bit, and really haven't found anything that says 2 versus 4 days.

Obviously, in a transverse skin incision, there forces are such that the incision is well approximated.

Steri-strips? I've always used these because someone taught me to do so.

Garry

--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA

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