Re: type of incision?
From: verner nellsch (vnellsch@eastex.net)
Thu Jul 31 06:15:53 2008
eberhard,
so good to hear from you. how are things? you seem a little, well, tense.
try what i do, just run laps.
i buy the softest shoes i can, nikes or reeboks. my feet hurt, a condition
to which many old farts like you and me are subject.vnellsch
>----- Original Message -----
From: "Dr Eberhard Lisse" <el@lisse.NA>
To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.obgyn.net>
Sent: Thursday, July 31, 2008 6:00 AM
Subject: Re: type of incision?
> You, my little orifice, mentioned the word slander.
>
> And, aren't you too old for Nikes? I got a pair of leather
> Converse, almost 30 years old, too valuable to run around
> at the hospital in.
>
> el
>
> on 7/31/08 11:40 AM verner nellsch said the following:
>> eberhard,
>>
>> what a classy guy you are.
>>
>> one usually has to go to a bowling alley to meet someone of your stature.
>> the butler in arthur.
>>
>> vnellsch.
>>> ----- Original Message ----- From: "Dr Eberhard W Lisse" <el@lisse.na>
>> To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.obgyn.net>
>> Sent: Thursday, July 31, 2008 12:52 AM
>> Subject: Re: type of incision?
>>
>>> No, it is to assist Shabanay Nellsch with looking up the definition.
>>>
>>> el
>>>
>>> On 31 Jul 2008, at 03:51 , Gerald P. Rodríguez wrote:
>>>
>>>> What is going on here? We have someone, presumably intelligent,
>>>> sending us ignorant peasants the definition of the Trendelenburg
>>>> position. Is this raw pedantry or what!?
>>>>
>>>> Gerald P. Rodríguez, M.D., FACOG
>>>> Santa Fe
>>>>
>>>>> ----- Original Message ----- From: "Raymond Stephen"
>>>> <Stephen.Raymond@dhhs.tas.gov.au
>>>> >
>>>> To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.obgyn.net>
>>>> Sent: Wednesday, July 30, 2008 6:44 PM
>>>> Subject: RE: type of incision?
>>>>
>>>>> Start with some Trendelenburg (head down tilt). Perform a transverse
>>>>> incision just above the fold where the pannus reaches the mons. Make
>>>>> the rectus sheath incision wider than usual to compensate for the
>>>>> depth of the fat. Keep a heavy tissue forceps on the upper edge of
>>>>> rectus sheath and fix it in some way to retract constantly throughout
>>>>> the operation.
>>>>> Infection incidence is probably no different between midlines and
>>>>> transverses, but the potential consequences in a midline are much
>>>>> worse. I know of no evidence that proves that prophylactic
>>>>> antibiotics prevent wound infection, but it is likely. I don't think
>>>>> suture material has any bearing. Attention to minimising tissue
>>>>> trauma, bleeding, haematoma formation and tight bulky suturing are
>>>>> all good strategies.
>>>>>
>>>>> Steve Raymond
>>>>> Ph (03)62227898
>>>>> Cell 0438372395
>>>>> -----Original Message-----
>>>>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>>>>> rmodugno@aol.com
>>>>> Sent: Thursday, 31 July 2008 9:49 AM
>>>>> To: Multiple recipients of list OB-GYN-L
>>>>> Subject: RE: type of incision?
>>>>>
>>>>> -----Original Message-----
>>>>> From: Raymond Stephen <Stephen.Raymond@dhhs.tas.gov.au>
>>>>> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net>
>>>>> Sent: Tue, 29 Jul 2008 9:35 am
>>>>> Subject: RE: OB didelphyic/bicornuate and breech --> type of
>>>>> incision?
>>>>>
>>>>> The best approach in an obese patient in
>>>>> obstetrics is the one that allows you to do what you have to do
>>>>> without
>>>>> postoperative risks. In my view that means avoiding a midline,
>>>>> because
>>>>> you only need access to the lower segment and sufficient width to
>>>>> deliver the
>>>>> baby.
>>>>>
>>>>> Steve Raymond
>>>>>
>>>>> Ph (03)62227898
>>>>>
>>>>> Cell 0438372395
>>>>>
>>>>> =================================
>>>>>
>>>>> Steve, I know physicians who use the same suture for transverse
>>>>> incisons and these patient types get infected no matter the abdominal
>>>>> approach.
>>>>>
>>>>> What is your approach to the obese patient with a large
>>>>> pannus/panniculus?
>>>>>
>>>>> Robert Modugno MD MBA FACOG
>>>>> Sylva, NC
>>>>
>>>
>>
>
> --
> Dr. Eberhard W. Lisse \ / Obstetrician & Gynaecologist (Saar)
> el@lisse.NA el108-ARIN / * | Telephone: +264 81 124 6733 (cell)
> PO Box 8421 \ / Please do NOT email to this address
> Bachbrecht, Namibia ;____/ if it is DNS related in ANY way
