Re: staples at C/S
From: Atkinson, Samuel M (ATKINSONS@ECU.EDU)
Sun Jul 30 20:26:37 2006
>From painful, personal experience, my cardiac cutter used steristrips with 3 mm. intervals. I likened that to using scotch tape but he did accept my insurance payment as payment in full!!
sAm
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From: ob-gyn-l@obgyn.net on behalf of Lynn Montgomery, MD
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Sent: Sat 7/29/2006 11:58 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: staples at C/S
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
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Garry E. Siegel, M.D.
Private Practice
Roswell, GA
