Re: Keloids
From: Anna Meenan, MD (annam@uic.edu)
Tue Dec 14 18:56:46 2004
Not quite 20 years ago, when I was just starting out, I had a mom who
was very needle-phobic. She would allow needle-sticks when pregnant, if
it was necessary for the benefit of the baby. I didn't do an epis when
she delivered, and she had a second-degree tear, fairly even and in the
midline. Because she was no longer pregnant, she absolutely refused to
allow me to repair the tear. Since the edges fell together rather
neatly, I left it unrepaired (after lengthy discussion of the risks of
bleeding, infection, poor healing, etc, documented in chart and signed
by patient), and it healed beautifully. I have never been tempted to
leave something that large unrepaired since then, but I have left a lot
of smaller stuff unstitched and they all healed beautifully.
--
Anna Meenan, MD
At Tue, 14 Dec 2004, ainsron wrote:
>
>You could always clamp it with allis clamps for a couple of hours and avoid
>sutures, at least from what I have heard from some "older" guys. On the
>other hand, try and avoid an episiotomy, use good perineal support, etc.
>
>Ronald E. Ainsworth
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Elrod
>Darryl G MAJ 48 MDOS/SGOBO
>Sent: Tuesday, December 14, 2004 5:04 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Keloids
>
>I have no idea. She was very clear though that her sister told her that
>they had to use something special because of her history of keloids. All I
>can figure is that maybe they used something like a Vicryl Rapide since it
>supposedly dissolved quicker???
>
>Glen
>
>D. Glen Elrod, Maj USAF, MC
>
>Obstetrician/Gynecologist
>
>Maternal Child Flight
>
>48 MDOS/SGOBO
>
>UNIT 5210 Box 23
>
>APO, AE 09464
>
>DSN (314) 226-8334
>
>Comm 01638-52-8334
>
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>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Braun, R.
>Daniel
>Sent: Tuesday, December 14, 2004 12:02 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Keloids
>
>What "Special Sutures" ?????
>
>R. Daniel Braun, MD
>
>"If everyone likes you, you're doing something wrong."
>
>Kinky Friedman
>
>I believe a self-righteous liberal or conservative with a cause is more
>dangerous than a Hell's Angel with an attitude.
>
>Andy Rooney
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Elrod
>Darryl G MAJ 48 MDOS/SGOBO
>Sent: Tuesday, December 14, 2004 4:00 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Keloids
>
>Anyone know if there is a screening test for keloid formation? I just had a
>patient at 17wks tell me her twin sister forms keloids and had to have
>'special sutures' to repair her episiotomy site to prevent keloids. My pt
>wants to be tested if possible.
>
>Any ideas on either the test (doubtful) or the suture in question?
>
>Glen
>
>D. Glen Elrod, Maj USAF, MC
>
>Obstetrician/Gynecologist
>
>Maternal Child Flight
>
>48 MDOS/SGOBO
>
>UNIT 5210 Box 23
>
>APO, AE 09464
>
>DSN (314) 226-8334
>
>Comm 01638-52-8334
>
>Notice of Confidentiality
>Under the Privacy Act of 1974, you must safeguard all information reflected
>on this Email and, if applicable, all attachments. Disclosure of
>information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI 37-132, AFI
>33-219, and PL 93-579"
>This document may contain information covered under the Privacy Act, 5 USC
>552(a), and/or the Health Insurance Portability and Accountability Act (PL
>104-191) and its various implementing regulations and must be protected in
>accordance with those provisions. Healthcare information is personal and
>sensitive and must be treated accordingly. See
><https://sg.usafe.af.mil/HIPAADisclosure.cfm> for full details.
