What is technique of episiotomy?
Technique. An episiotomy is performed using either scissors or a scalpel. The median episiotomy incision should begin at the posterior fourchette, to avoid the Bartholin glands, and run downward through the perineal body.
What is the best suture choice for closing an episiotomy?
Derivatives of polyglycolic acid (marketed as Dexon and Vicryl) appear to be the absorbable material of choice for both deep and skin closure. Compared with catgut their use is associated with about a 40% reduction in short-term pain and need for analgesia.
What type of suture is used during perineal repair?
Two types of sutures using different techniques were used for perineal injury repairs. Continuous sutures were used in group A and interrupted sutures in group B. The two techniques and sutures are described in more detail in the Supplementary information.
How many layers are sutured in episiotomy?
A midwife or doctor will stitch the episiotomy or second‐degree tear in three layers (vagina, perineal muscle and skin).
What are the four types of episiotomy?
Types of episiotomy. 1: median episiotomy, 2: modified median episiotomy, 3: ‘J’-shaped episiotomy, 4: mediolateral episiotomy, 5: lateral episiotomy, 6: radical lateral (Schuchardt incision), 7: anterior episiotomy (white arrow).
How do we suture episiotomy?
Step 1: Place a suture (stitch) at the apex of the incision in the vaginal epithelium. Then insert one or two more continuous sutures in the vaginal epithelium. Do not complete suturing the vaginal epithelium when the episiotomy is large or deeply cut but leave this suture and do not cut it.
Which suture used in episiotomy?
different suture materials, namely, vicrylrapide and chromic catgut for episiotomy repair, in relation to a short-term maternal morbidity. They concluded that vicryl rapide was the ideal suture material for episiotomy repair, which resulted in less perineal pain and a better wound healing .
What is 4th degree episiotomy?
Fourth-degree vaginal tears are the most severe. They extend through the anal sphincter and into the mucous membrane that lines the rectum (rectal mucosa). Fourth-degree tears usually require repair with anesthesia in an operating room — rather than the delivery room — and sometimes require more specialized repair.
What is J shaped episiotomy?
‘J’-shaped episiotomy This episiotomy commences with a midline incision and is then curved laterally to avoid the anus. 12, 13. In this technique curved scissors are used starting in the midline of the vagina until the incision is 2·5 cm from the anus.
What type of suture is used for an episiotomy?
Either 2-0 or 3-0 sutures (of the same materials as used for midline episiotomy) may be used for the repair. With 2 fingers placed in the vagina for retraction, the apex of the episiotomy site is identified, and a suture is secured approximately 1 cm proximally.
How do you repair an episiotomy?
Episiorrhaphy repair is very important and should not be left for junior doctors. It is usually repaired in 3 layers. Insert a perineal pad into the birth canal to prevent bleeding and lochia from obscuring the operating field Locate the apex of the episiotomy and go 1cm above to avoid damaging some blood vessels which might have retracted
What size stitches are used for episiotomy repair?
In most instances, 2-0 and 3-0 sutures are suitable for reapproximation and repair of soft tissue in an episiotomy repair. For optimal visualization, repair should take place in a labor and delivery room or an operating room with appropriate lighting.
Does continuous suture technique affect perineal pain and dyspareunia after episiotomy?
The effect of suture techniques used in repair of episiotomy and perineal tear on perineal pain and dyspareunia It was aimed to determine the effect of continuous technique for repair of episiotomy and spontaneous tear repair compared to interrupted suture technique for perineal pain and dyspareunia.