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Wednesday, April 15, 2009

Episiotomy Repair

1:16 PM

Also known as

Perineorrhaphy


Description

# Perineorrhaphy is the surgical repair of the perineum, usually after an episiotomy has been made to assist the delivery of a baby and decrease damage to the mother's perineum and its structures, e.g., urethra. However, a perineorrhaphy is the repair of any tear or laceration to the perineum.

Procedure

# Using a local or regional anesthetic, the cut or laceration is repositioned as close as possible to the original position using absorbable sutures, which dissolve in about 10 days and do not have to be removed.



Complications

# Infection of the wound
# Separation of the wound



Postsurgical Care

To prevent complications, the sutured wound should be kept clean and dry. It is impossible to keep it totally sterile because of the location.
# Remove pads and use toilet paper from front to back to avoid contaminating the wound, urethra, and vagina with feces.
# Wash hands before and after performing wound care, changing perineal pads, urinating, and defecating.
# Avoid constipation and straining by eating fresh fruits, vegetables, cereals, and using stool softeners.
# Inspect the wound to see that is healing and if the wound is closed.
# Lochia, the uterine discharge that commonly occurs after delivery, should decrease. Report any bright red bleeding or foul smelling discharge, which may indicate an infection in the uterus.
# The discomfort associated with perineorrhaphy should subside in 4 or 5 days; otherwise consult your physician if pain increases.
# Discomfort can be relieved by a cream or suture line spray and application of intermittent cold packs and heat, in the form of sitz baths for the first 24 hours, or a heat lamp or a rubber K-pad, through which warm water circulates. Make sure someone teaches you how to use these correctly.
# Kegel exercises also help relieve discomfort and promote healing by increasing circulation to and relieving edema at the operative site.
# To avoid discomfort while sitting, squeeze the buttocks together before sitting.
# Do not put anything (tampons, douche, etc.) into the vagina until your doctor says it is safe to do so.

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