Re: two week check up WAS staples at C/S
From: D. Ashley Hill (dahmd@cfl.rr.com)
Tue Aug 1 17:16:52 2006
For many years we have scheduled cesarean patients for a 2 week "nurse
visit" and a 6 week physician visit. Patients rarely have to wait for
the nurse visit. They bring the baby and a photo for our wall, chat
with the office staff about their delivery, and one of our nurses checks
their incisions. If there is a problem the nurse notifies a physician
who drops by to see the patient. It's worked extremely well for our
patients and our group.
Ashley
t Tue, 1 Aug 2006, Efrain Ramirez wrote:
>
>Most of the time that visit is spent on telling their experiences, how
>they are trying to cope with new situations - etc.. things they liked
>about our hospital - things they did not - there are doubts and fears of
>they can do or can not do - future contraception -- you might even find
>a "rubella suceptible" patient that the vaccine was not given - - you
>never know - so, no - I don't think it is a waste of their time nor
>mine.. IMO-
>
>Ef
>
>>At Tue, 1 Aug 2006, Elrod, Darryl G Maj 48 MDOS/SGOBO wrote:
>>
>>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
>>
>>Telephone DSN: 314-226-8130
>>
>> Comm: +44 (0) 1638 52 8130
>>
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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
>>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
>>
>--
>“ The greatest obstacle to knowledge is not ignorance,
>it is the illusion of knowledge.” Daniel J. Boorstin - Historian
>
--
D. Ashley Hill, MD
Associate Director
Department of Obstetrics and Gynecology
Florida Hospital Family Practice Residency
Medical Director, Loch Haven Ob/Gyn Group
Division Director, Dept. of Ob/Gyn, Florida Hospital Orlando
Orlando, Florida
