Re: staples at C/S
From: R. Daniel Braun (rd.braun@gmail.com)
Sat Jul 29 14:27:01 2006
Insorb The absorbable staple.
On 7/29/06, Lynn Montgomery, MD <apgar10@qwest.net> wrote:
>
> Garry,
> I was a subcuticular closure person for the first few years out of
> practice.
> Then almost simultaneously, I had two patients react to the suture and
> broke
> down their closure and about the same time, the studies came out
> demonstrating that the ultimate "scar" was the same for subcuticular
> versus
> staples. I bagged the subcuticular for those reasons and have stapled
> ever
> since.
>
> In the past few months, I have had several patients request a subcuticular
> closure (must have been an article in Cosmopolitan of something). I
> explain
> my experience to patients and they typically understand. I to have had my
> midwives comment on this and have had to explain my way out of situations
> because they have told patients that I do it because it is faster. That
> is
> true, but not the reason I do it. Bottom line is there is no difference
> in
> the ultimate outcome so you do what you are most comfortable doing, as the
> surgeon. Can you imagine the cardiovascular surgeons response to somebody
> telling them how to close a chest...
> Lynn
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E.
> Siegel, M.D.
> Sent: Saturday, July 29, 2006 9:11 AM
> To: Multiple recipients of list OB-GYN-L
> Subject: Ob: staples at C/S
>
> Dear all:
>
> Over the last 3 years since being in a collaborative practice, many of our
> CNM patients who seem to be a bit more "natural" (maybe many of them have
> taken Bradley classes) are insistent to a fault about having subcuticular
> sutures, not staples, for their unplanned C/S closure.
> Honestly, it is almost as predictable as the sun rising in the east!
> When I tell them that I prefer staples, and haven't sutured skin in years
> (and thus am a bit out of practice), well, many seem taken aback.
>
> I have found that I don't want to tell the
> mechanic/gardener/plumber/electrician etc. how to do his job, yet this
> seems the opposite to me.
>
> What's up with that?
>
> Garry
>
> --
> 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
