RE: Ob:  staples at C/S

From: Elrod, Darryl G Maj 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL)
Mon Jul 31 04:07:37 2006


So I assume your c-sections all stay for 72 hours? I guess this is another reason I like to suture as all mine go home in 48 hours (not to start getting us off on that tangent again) so removing them even at 72 hrs would require a trip back to the hospital (clinic)

Glen

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Obstetrician/Gynecologist

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48 MDOS/SGOBO

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-----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. Siegel, M.D. Sent: Sunday, July 30, 2006 4:35 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Ob:  staples at C/S

Ken:

I am in Joe's camp on this.

I believe that the literature shows equivalent healing, etc. with sutures v. staples.

The extra few minutes is a non-factor for me.

I (or the fine surgical assistant to which Robert alluded) put in a SQ for folks going home in a couple of days, i.e. I've done two open myomectomies and they had sutures.

At a C/S, if you take out the staples in 3 days, as I do, I've just not seen any staple holes, and the incisions are straighter. A small number of patients complain, but most don't. I find that taking the staples out myself on the day of discharge allows me time to go over instructions, etc., while removing them.

I've actually been very impressed with a SQ Prolene with the ends out lateral to the incision, placing steri-strips, and removing the suture in a few days. I've done this to prior keloids that I've excised, upon the advise of a friendly plastic surgeon. The reason I don't do all cases this way is that it requires a trip back to the office.

Garry

At Sat, 29 Jul 2006, DoctorJoe@aol.com wrote: >
>In a message dated 7/29/06 8:36:00 PM, kthomas719@hotmail.com writes:
>
>> Staples have only one advantage over subcuticular closure-speed.
>> Otherwise, they are painful to remove (the patient feels each one), they
>> leave gaps in the incision when removed, and they invariably produce
>> uglier scars, including the "dotted lines" when left in situ for too
>> long.  Since the scar is the only visual indicator of teh quality of
>> your surgery that the patient (and her friends and family) will ever
>> see, it is clearly advangtageous for you to minimize the discomfort and
>> maximize the appearance of her scar.  It's well worth a few more minutes
>> of your time and effort in the OR.
>>
>Following my own experience, I would pretty much disagree with each
>individual point you've asserted.
>
>Joe P.

--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA




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