Re: Single Layer vs Double Layer Uterine Closure
From: Dr. Bulent Potur (bpotur@ttnet.net.tr)
Thu Nov 6 00:52:47 2003
By the way Dan after a single NON-locking closure of the myometrium do
you close the visceral peritoneum with 00 locking cat-gut?
Personally I am trying to perform Misgav-Ladach procedure for the last
three years though I have not seen it performed originally. I always
try not to close the visceral peritoneum but it usually bleeds so I have
to close it.
Bulent Potur
http://web.ttnet.net.tr/emain
At Wed, 5 Nov 2003, Braun, R. Daniel wrote:
>
>An extra interrupted if needed. Seldom is as I close the whole thing
>through and through.
>
>Dan
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf
>Of Douglas Krell
> Sent: Wednesday, November 05, 2003 11:20 AM
> To: Multiple recipients of list OB-GYN-L
> Subject: Re: Single Layer vs Double Layer Uterine Closure
>
> Dan
> With a single NON-locking closure, what steps do you take to
>control areas of bleeding?
>
> Douglas Krell MD
>
>>> ----- Original Message -----
> From: Braun, R. Daniel <mailto:rbraun@iupui.edu>
> To: Multiple recipients of list OB-GYN-L
><mailto:ob-gyn-l@dns.obgyn.net>
> Sent: Wednesday, November 05, 2003 7:43 AM
> Subject: RE: Single Layer vs Double Layer Uterine
>Closure
>
> Locking creates necrosis within the locked area of
>tissue.
>
> Dan
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On
>Behalf Of
> Richard Chudacoff, MD
> Sent: Wednesday, November 05, 2003 9:25 AM
> To: Multiple recipients of list OB-GYN-L
> Subject: RE: Single Layer vs Double Layer Uterine
>Closure
>
> Why would not locking make that much of a difference?
>I've always locked
> (and I must say, Dan, my numbers are probably far less
>then yours just
> based on expose to the practice) and have seen my
>incisions on repeat
> sections that look quite sturdy. Nor am I aware of any
>of successive
> pregnancies after my c-section that has ruptured. Of
>course, my case
> list is slightly* less than 10,000.
>
> *-probably less than 1000 as well-not including my Ben
>Taub experience.
>
> Richard Chudacoff, MD
>
> The more laws, the less justice.
> Marcus Tullius Cicero
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On
>Behalf Of Braun,
> R. Daniel
> Sent: Wednesday, November 05, 2003 7:48 AM
> To: Multiple recipients of list OB-GYN-L
> Subject: RE: Single Layer vs Double Layer Uterine
>Closure
>
> If you all remember, I made a big point out of the fact
>that in the
> McGill study, all of the single layer closures were
>running lock
> stitches. This article does not state whether or not
>the single layers
> were locked. It just says a continuous running suture. I
>would think
> that they were not locked since it doesn't specify, but
>you know what
> assuming does. I have closed mine with a running NON
>locked single layer
> of Number 1 chromic catgut for a long time. I really
>think that not
> locking makes a big difference.
>
> Dan
>
--
Bulent Potur M.D. Obgyn.
http://medpages.obgyn.net/docdetail.cfm?sn=424
