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RE: Ob: staples at C/SFrom: Elrod, Darryl G Maj 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL)Mon Jul 31 03:30:00 2006
I like that comment. I think that is probably the reason that I continue to suture all my incisions. Staples just don't give me much satisfaction when I see the patients back and look at the scars. I know that without a doubt the two closures result in the same appearance. Suturing just seems like you took more care in closing it. Perception is worth something. All the staff like to chuckle when they ask me if I want the stapler. Other than a vertical incision, I can't remember the last incision I stapled. Glen //SIGNED// D. Glen Elrod, Maj., USAF, MC Obstetrician/Gynecologist Chief of Obstetrics 48 MDOS/SGOBO RAF Lakenheath, England Telephone DSN: 314-226-8130 Comm: +44 (0) 1638 52 8130 Notice of Confidentiality Under the Privacy Act of 1974, you must safeguard all information reflected on this e-mail 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 e-mail message including any attachments is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. Any questions pertaining to disclosure should be directed to the privacy officer. -----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 8:29 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Ob: staples at C/S
an).
> 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 Bingo, and thanks. I am the patient's (not the husband, thank you Bradley method) physician, not their waiter. I have a greater calling and responsibility than the waiter, or the plumber, with no disrespect to those fine individuals. Obviously, there must be something out there in the circles in which these patients travel, and I bet that the time factor ("the DOCTOR is in a hurry") may be some part of it. Dr. Potur's comment regarding courtesy is important, but I contend that, at the end of the day, a courteous request to do that which you don't think proper (i.e. I want you to use stitches, even though that's not what you're good at) is simply foolhardy and so inappropriate. Yesterday, I did two sections for patients of our CNMs, both of whom asked for stitches, and both of whom got staples. The first, a failed VBAC, when asked why she wanted stitches, said: "Because staples are so impersonal." That was a new one. Garry That said, I wish that the tile man and the plumber would get finished in our bathroom!
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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