Re: One layer uterine closure
From: R. Daniel Braun (rd.braun@gmail.com)
Sat Sep 2 07:17:27 2006
I have used #1 chromic because it has a large needle which makes it easier
to close the uterus.
Have any of you gone back in 24-48 hours post op on a C/S? The incision is a
lot shorter because the uterus has started to involute. The suture is the
same length that it was and is holding no tension on anything and that is
true no matter what type of closure one did, except for interrupted.
Dan
re
On 9/2/06, Laure <lfolgar@vianwe.com> wrote:
>
> Most of spanish obstetricians are doing now one continuous layer. For
> many years, the standard was; first continuous and second a Lembert-like
> discontinuous, teorically to avoid adhesions by eliminate the lesionated
> uterus contact peritoneum. There´s no doubt about the elegance of this
> procedure, but I´m not sure that avoid adhesions. If you have time is
> good for training in surgery to residents, without complications. With
> residents, one continuos layer make me more than one problem when i was
> call for reoperate a opened uterus who lost a knot.
> Althoug in Spain VBAC is always tried.
>
> Economics are making diference in surgery, are we sure this is the right
> way?.
>
> In Spain, cromic are forbiden by a political decision in the mad cows
> disaster.
>
> -----Mensaje original-----
> De: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] En nombre de Dr
> Eberhard Lisse
> Enviado el: sábado, 02 de septiembre de 2006 8:54
> Para: Multiple recipients of list OB-GYN-L
> Asunto: Re: One layer uterine closure
>
> Bernard,
>
> There is no standard in Europe.
>
> In Europe there are at least 6 schools of thought that I know personally
> of, French, UK, West and East German, Romanian and Russian. And I have
> no clue what happens in Spain, Italy and other places.
>
> The rupture rates have nothing to do with other countries per se, but
> perhaps with other techniques.
>
> I don't think 2 layers is worse than one, takes one minute longer, and
> makes me feel better. I *HAVE* seen onlayer closure com eloose once with
> catastrophic results.
>
> el
>
> on 9/2/06 7:23 AM Bernard Cristalli said the following:
> > One layer closure has been the standard of care here (France, and
> > Europe I believe) for the last 40 years. I haven't seen our rupture
> > rates at VBAC are higher than others, and we perform a lot of VBACs.
> > BC
>
--
R. Daniel Braun
"The way to health is an aromatic bath and scented massage everyday"..
Hippocrates
