Literature DB >> 23997884

A novel approach to teaching placement of a B-lynch suture: description of technique and validation of teaching model.

Patrick F Vetere, Christopher P Wayock, Jolene Muscat, Genevieve Sicuranza.   

Abstract

INTRODUCTION: Postpartum hemorrhage is a major cause of maternal morbidity and mortality throughout the world and uterine atony is the leading cause of postpartum hemorrhage. The B-Lynch brace suture is a fertility-sparing approach to treating intractable uterine atony at the time of cesarean delivery. However, many obstetricians lack confidence to perform this procedure, which they may not have performed during residency. In order to train all residents to perform the B-Lynch brace suture, we developed a realistic model by using a flank steak to imitate a gravid uterus.
METHODS: A convenience sample of obstetrics-gynecology faculty and residents at different levels of training at a single large hospital participated in this pilot project. Each physician reported self-perceived understanding of and confidence in performing the B-Lynch procedure before and immediately after practicing the technique using the flank-steak model, via a Likert-type survey (scale 1  =  low, 5  =  high). A Wilcoxon matched-pairs signed rank test was used to compare the before and after responses.
RESULTS: Thirty-four participants completed the flank-steak model training and pretraining/posttraining surveys. The median score (range) for self-perceived understanding was 4 (2-5) and increased to 5 (4-5) (P < .01) after exposure to the training model. The confidence scores rose from 3 (1-5) to 5 (4-5) (P < .01) after training.
CONCLUSION: The flank-steak model for teaching the B-Lynch suture significantly improved resident and faculty self-perceived understanding of and confidence in performing this procedure, which is otherwise rarely practiced in residency.

Entities:  

Year:  2012        PMID: 23997884      PMCID: PMC3444193          DOI: 10.4300/JGME-D-11-00186.1

Source DB:  PubMed          Journal:  J Grad Med Educ        ISSN: 1949-8357


  6 in total

1.  Surgical treatment of uterine atony employing the B-Lynch technique.

Authors:  J V Dacus; M T Busowski; J D Busowski; S Smithson; K Masters; B M Sibai
Journal:  J Matern Fetal Med       Date:  2000 May-Jun

Review 2.  Technical description of the B-Lynch brace suture for treatment of massive postpartum hemorrhage and review of published cases.

Authors:  Natalia Price; Christopher B-Lynch
Journal:  Int J Fertil Womens Med       Date:  2005 Jul-Aug

3.  Survey of surgical experience during training in obstetrics and gynaecology in the UK.

Authors:  S Ghaem-Maghami; E Brockbank; J Bridges
Journal:  J Obstet Gynaecol       Date:  2006-05       Impact factor: 1.246

4.  Uterine necrosis following B-Lynch suture for primary postpartum haemorrhage.

Authors:  E J Treloar; R S Anderson; H S Andrews; J L Bailey
Journal:  BJOG       Date:  2006-04       Impact factor: 6.531

5.  Management of primary postpartum haemorrhage.

Authors:  J Drife
Journal:  Br J Obstet Gynaecol       Date:  1997-03

6.  The B-Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported.

Authors:  C B-Lynch; A Coker; A H Lawal; J Abu; M J Cowen
Journal:  Br J Obstet Gynaecol       Date:  1997-03
  6 in total
  1 in total

1.  Emergency surgical obstetrics simulation training: an ex vivo low-cost model using bovine uterus and porcine bladder for haemostatic uterine brace suture techniques.

Authors:  Amy Sinclair; Mohamed Sayed Allam; Evelyn Jean Ferguson; Mohamed Khairy Mehasseb
Journal:  BMJ Simul Technol Enhanc Learn       Date:  2020-04-22
  1 in total

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