--
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: Thursday, November 06, 2003 5:39 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Single Layer vs Double Layer Uterine Closure
I include the visceral peritoneum in the single layer. This is one of
the hardest things to get residents to do. If you don't include
everything that you have cut in the stitch, it will bleed & you will
have to put in extra stitches or layers.
Dan
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Dr.
Bulent Potur
Sent: Thursday, November 06, 2003 2:54 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Single Layer vs Double Layer Uterine Closure
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
