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Re: hematomaFrom: Raymond Stephen (Stephen.Raymond@dhhs.tas.gov.au)Thu Nov 27 14:42:34 2008
I agree - the removal or cutting of a stitch is all it requires. There will be no active bleeding, as it is now more than a week since the original procedure, all that has happened is the haematoma formed immediately postoperatively, and is now liquefying and draining through whatever gap it can find. Be nice to your patient and help it along by opening a little more gap. That will make her feel so much better and allow spontaneous resolution. Antibiotic cover would be a good idea too. Steve Raymond Ph (03)62227898 Cell 0438372395 -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of vnellsch Sent: Friday, 28 November 2008 12:34 AM To: Multiple recipients of list OB-GYN-L Subject: Re: hematoma i'll tell you, joanne, when i have had cases like these, i have found it best to assure drainage by taking out a few sutures, then giving something like levaquin p.o., monitoring the cbc, and restraining myself from exploring unless the hct. gets too low. sometimes there is pressure from the patient and family to do something, but i think it is best to not explore unless you have a good reason. if they act litigious, i get a surgeon involved, who has always agreed with the course of action. of course, if they go down the road to dr. wonderful, who promptly takes them to surgery, then tells them that he/she saved their life, you are in a mess. good luck. vnellsch
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