Re: One layer uterine closure
From: R. Daniel Braun (rd.braun@gmail.com)
Wed Sep 6 13:35:29 2006
Much longer than is needed with a uterine scar at C/S
On 9/6/06, ainsron <ainsron@sbcglobal.net> wrote:
>
> There is a graph on the previously quoted page in Telinde that shows the
> tensile strength of chromic catgut falling to 60% at one week, 40% at 2
> weeks and 0% four weeks and complete absorption by 90 days. The data is
> based on Ethicon Research and compares it to plain gut, dexon, vicryl,
> maxon
> and PDS.
>
> Ronald E. Ainsworth, MD, FACOG
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E.
> Siegel, M.D.
> Sent: Tuesday, September 05, 2006 6:46 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: Re: One layer uterine closure
>
> I just looked at info on Monocryl and Coated Vicryl on Ethicon's site.
>
> Monocryl is absorbed in 90 to 119 days, and has 30 to 40% of its tensile
> strength at 2 weeks.
>
> Coated Vicry is absorbed in 56 to 70 days, and has75% of its tensile
> strength at 2 weeks, and 25% at 4 weeks.
>
> I could not find similar data for Chromic, and it is an Ethicon product.
>
> Garry
>
> At Wed, 6 Sep 2006, Raymond Stephen wrote:
> >
> >Not wishing to start a war, but I'm afraid Telinde is wrong. Chromic
> >catgut loses its strength inside ten days as against Vicryl which has a
> >minimum of three weeks and often up to six. The increased tissue
> >reaction is however, correct. Christopher is also wrong to say it takes
> >70 days to absorb plain catgut. It is unusual to see it persist beyond
> >7 days!
> >
> >Steve
> >
> >-----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
> >
>
> --
> Garry E. Siegel, M.D.
> Private Practice
> Roswell, GA
>
--
R. Daniel Braun
"The way to health is an aromatic bath and scented massage everyday".
Hippocrates
