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>Closure at C SectionsFrom: Richard Chudacoff, MD (richardc@bcm.tmc.edu)Tue Mar 11 09:13:21 1997
> >Another CLOSURE issue that I'm interested in is the tendency for the >Pfannenstiel incision to retract, creating an indentation that allows >the fat in the cephalad portion of the incision to hang over the lower >portion, creating an unsightly little bulge. Prevention of this >phenomenon is the primary reason that I reapproximate Scarpa's fascia >with interrupted 4-0 Monocryl or Vicryl. > >How do other's deal with this problem? Do you think that closing this >fascial layer prevents the problem? I have a few patient's who complain >bitterly about this effect in cases where I was did not take the time to >close Scarpa's, although in many cases of retrospectrive operative >report review, I never mention whether or not I actually closed the >layer. > I do this with my thin patients, as I have found that the sub-Q will adhere to the fascia, creating a depression at the incision site. The obese patients tend to fall together, although, unincumbered by data, I think closing this space may decrease risk of seromas. Rick
-- Richard Chudacoff, MD Assistant Professor, OB/GYN Baylor College of Medicine
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