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Bioadhesives For Repair Of Childbirth Lacerations

Bioadhesives are a reasonable alternative to sutures for repair of perineal lacerations sustained during childbirth, according to a poster presentation at last week’s annual meeting of the Society for Maternal-Fetal Medicine.

Researchers at the Hadassah Hebrew University Medical Center in Jerusalem randomized women with first degree perineal tears to either 2-octyl cyanoacrylate (Dermabond) adhesive glue or suture for wound closure. While healing and incisional pain was similar, women who received the adhesive closure were more satisfied than those who were sutured.

In Portugal, bioadhesives have been studied for closure of the top skin layer of an episiotomy repair, and found to shorten the duration of the procedure with similar outcomes to suture in terms of pain, healing, and infection.

Biologic adhesives are chemically related to Super Glue, which is ethyl-cyanoacrylate. Midwives have been using Super Glue for perineal wound repair for some time, according to Anne Frye, who has authored a book on wound closure for midwives, and who gives instructions for its use in repair of perineal lacerations. Apparently Super Glue was also used by the military during Vietnam for wound closure.

A PubMed search on Dermabond finds multiple studies of its use, from plastic surgery to mastectomy, surgical wound closure, retinal surgery, lung and gastric leak closure, and even on esophageal varices. RL Bates mentions Dermabond as an option to repair skin tears in elderly patients. This stuff is turning into the duct tape of the medical profession.

It’s important to remember that adhesives are only for superficial skin closure, as use in deeper layers can cause irritation and burning of tissues. Side effects of their use include irritation and allergic reactions and of course wound infections, and pain can always occur no matter how one closes a wound.

*This blog post was originally published at The Blog That Ate Manhattan*

When Doctors Deliver Babies Too Early

Babies born between the 34th and 36th week have more complications and cost the U.S. $26 billion annually. These children have more risk of death, cerebral palsy, cognitive impairment, or respiratory problems.

In the United States, nearly 13% of infants are born before they reach 37 weeks gestation. According to the Society for Maternal-Fetal Medicine (SMFM), that rate is much higher than other developed nations, and physicians may be partially to blame for the early deliveries.

Some of the reasons may be older moms or the increased use of artificial reproductive technology and multiple births, but some physicians are choosing to deliver between 34 and 37 weeks even when there is no clear medical indication. Read more »

*This blog post was originally published at EverythingHealth*

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