Re: One layer uterine closure
From: art fougner, md (evsono@pipeline.com)
Tue Sep 5 15:15:19 2006
And on which study of Cesarean incision healing is this dictum based?
I'm sorry but this may violate the "If it ain't broke, don't fix it"
aphorism.
Art
At Tue, 5 Sep 2006, ainsron wrote:
>
>Thanks for the reference in Telinde. I have one colleague who still uses
>chromic for episiotomies and C/S. I'll send him a copy of the page.
>
>Ronald E. Ainsworth, MD, FACOG
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Atkinson,
>Samuel M
>Sent: Tuesday, September 05, 2006 7:53 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: One layer uterine closure
>
>We have previously been thru this subject. According to Christopher's
>Text of Surgery, there is no place for the use of catgut in the human.
>This is because of its' enormous inflammatory response. Plain catgut is
>totally absorbed in 70 days at the expense of the most significant
>inflammatory reaction. This is why we are foolish to use plain gut for
>reperitonealization. Chromic has essentially the same absorption pattern
>as polyglycolic (read vicryl/monocryl) but with a significant tissue
>reaction. Tensile strength, however lasts longer.
>To again quote the latest edition of Telinde, Seventh Edition. p.232,
>"...Catgut should not be routinely used in gynecologic surgery. Indeed,
>there remains little indication for the use of catgut in any gynecologic
>procedure."
>sAm
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>Raymond Stephen
>Sent: Monday, September 04, 2006 7:26 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: One layer uterine closure
>
>1. Catgut is absorbed faster - often an advantage.
>2. Catgut is somewhat stiffer so it stands up when you are trying to
>find an end to tie.
>3. Catgut is somewhat smoother than Vicryl
>
>These are reasons to use catgut. That doesn't mean I don't like Vicryl
>but it has its place.
>
>Steve
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Dr
>Eberhard Lisse
>Sent: Monday, 4 September 2006 2:23 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: One layer uterine closure
>
>Art,
>
>I don|t know. But what I know, is that the US government was quite ready
>to ban blood donors if they just set foot down in Europe.
>
>What I also know is that (bio-)chemistry doesn't lie.
>
>And, when paying attention a bit, I usually don't tear it through the
>muscle.
>
>So, why use catgut (and/or chromic)?
>
>el
>
>--
>Dr. Eberhard W. Lisse \ / Obstetrician & Gynaecologist (Saar)
>el@lisse.NA el108-ARIN / * | Telephone: +264 81 124 6733 (cell)
>PO Box 8421 \ / Please send DNS/NA-NiC related e-mail
>Bachbrecht, Namibia ;____/ to dns-admin@na-nic.com.na
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
