Re: type of incision?
From: Dr Eberhard Lisse (el@lisse.NA)
Thu Jul 31 05:59:24 2008
You, my little orifice, mentioned the word slander.
And, aren't you too old for Nikes? I got a pair of leather
Converse, almost 30 years old, too valuable to run around
at the hospital in.
el
on 7/31/08 11:40 AM verner nellsch said the following:
> eberhard,
>
> what a classy guy you are.
>
> one usually has to go to a bowling alley to meet someone of your
> stature. the butler in arthur.
>
> vnellsch.
>> ----- Original Message ----- From: "Dr Eberhard W Lisse" <el@lisse.na>
> To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.obgyn.net>
> Sent: Thursday, July 31, 2008 12:52 AM
> Subject: Re: type of incision?
>
>> No, it is to assist Shabanay Nellsch with looking up the definition.
>>
>> el
>>
>> On 31 Jul 2008, at 03:51 , Gerald P. Rodríguez wrote:
>>
>>> What is going on here? We have someone, presumably intelligent,
>>> sending us ignorant peasants the definition of the Trendelenburg
>>> position. Is this raw pedantry or what!?
>>>
>>> Gerald P. Rodríguez, M.D., FACOG
>>> Santa Fe
>>>
>>>> ----- Original Message ----- From: "Raymond Stephen"
>>> <Stephen.Raymond@dhhs.tas.gov.au
>>> >
>>> To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.obgyn.net>
>>> Sent: Wednesday, July 30, 2008 6:44 PM
>>> Subject: RE: type of incision?
>>>
>>>> Start with some Trendelenburg (head down tilt). Perform a
>>>> transverse incision just above the fold where the pannus reaches
>>>> the mons. Make the rectus sheath incision wider than usual to
>>>> compensate for the depth of the fat. Keep a heavy tissue forceps
>>>> on the upper edge of rectus sheath and fix it in some way to
>>>> retract constantly throughout the operation.
>>>> Infection incidence is probably no different between midlines and
>>>> transverses, but the potential consequences in a midline are much
>>>> worse. I know of no evidence that proves that prophylactic
>>>> antibiotics prevent wound infection, but it is likely. I don't
>>>> think suture material has any bearing. Attention to minimising
>>>> tissue trauma, bleeding, haematoma formation and tight bulky
>>>> suturing are all good strategies.
>>>>
>>>> Steve Raymond
>>>> Ph (03)62227898
>>>> Cell 0438372395
>>>> -----Original Message-----
>>>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>>>> rmodugno@aol.com
>>>> Sent: Thursday, 31 July 2008 9:49 AM
>>>> To: Multiple recipients of list OB-GYN-L
>>>> Subject: RE: type of incision?
>>>>
>>>> -----Original Message-----
>>>> From: Raymond Stephen <Stephen.Raymond@dhhs.tas.gov.au>
>>>> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net>
>>>> Sent: Tue, 29 Jul 2008 9:35 am
>>>> Subject: RE: OB didelphyic/bicornuate and breech --> type of incision?
>>>>
>>>> The best approach in an obese patient in
>>>> obstetrics is the one that allows you to do what you have to do
>>>> without
>>>> postoperative risks. In my view that means avoiding a midline,
>>>> because
>>>> you only need access to the lower segment and sufficient width to
>>>> deliver the
>>>> baby.
>>>>
>>>> Steve Raymond
>>>>
>>>> Ph (03)62227898
>>>>
>>>> Cell 0438372395
>>>>
>>>> =================================
>>>>
>>>> Steve, I know physicians who use the same suture for transverse
>>>> incisons and these patient types get infected no matter the abdominal
>>>> approach.
>>>>
>>>> What is your approach to the obese patient with a large
>>>> pannus/panniculus?
>>>>
>>>> Robert Modugno MD MBA FACOG
>>>> Sylva, NC
>>>
>>
>
--
Dr. Eberhard W. Lisse \ / Obstetrician & Gynaecologist (Saar)
el@lisse.NA el108-ARIN / * | Telephone: +264 81 124 6733 (cell)
PO Box 8421 \ / Please do NOT email to this address
Bachbrecht, Namibia ;____/ if it is DNS related in ANY way
