The B-Lynch suture is a form of compression suture used to mechanically compress an atonic uterus in the face of severe postpartum hemorrhage. To simulate a B-Lynch compression suture, we use neoprene models. While practicing on these models, trainees discuss the indications for B-Lynch, learn the correct suture material, and develop tactical muscle memory for performing a B-Lynch suture.
Model uterus Materials:
- Wash mitt (used in GO MOMS video)
- Table clamp to secure uterus to table
- Neoprene sleeve cover for iPad
- Neoprene wine tote bag
- Neoprene golf club head cover
- Grapefruit or pomelo
- Needle driver
- Pick ups
- Hemostat or small clamp
- Absorbable suture only, size 1-0 or 0, with larger needle (ex: CT or CTX)
Supplies: Wash mitt and surgical supplies
- Turn the wash mitt inside out with the opening at the bottom. Secure the bottom of the mitt to the table using the plastic bar clamp.
- Use a marker to denote where the hysterotomy incision would be located for reference while stitching.
Alternatives to the wash mitt for representing the uterus.
In real life situation, only use absorbable suture. Assistant will help keep suture in place and firmly squeeze the uterus while tying down the suture.
Uterus model can also be used to practice other uterine stitches such as uterine artery ligation (or O’Leary stitch).