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Monday, April 13, 2009

Perineotomy Region

11:46 AM

Description

# Many germs inhabit the surrounding perineotomy region, but childbirth wounds can heal quickly without medical intervention.
# Unless infection and hematoma are present, the perineotomy region (i.e., perineum, the space between anus and the vulva) requires only a sitz (hip) bath to heal.


# Pain

# As the perineotomy region heals, tightening pain will continue for 2-3 days after birth and make walking and sitting uncomfortable. But the pain should ease by the time the stitches are removed.
# In the United States and other countries, an anesthetic spray is administered to reduce pain; in Korea, however, hospitals and physicians administer painkillers.
# The pain itself can be from the perineotomy, but if the pain is severe, complications such as necrotizing fasciitis should be considered.


Inflammation

# If there is inflammation in the surrounding tissue, the stitching may look clean but the surrounding area will be reddish, swollen, warm, and painful to touch.
# This must be treated quickly with an antibiotic, because the inflammation could spread or the wound could open.
# If the wound tears a little and the inflammation disappears, it will heal. However, if a considerable tear exists, it will need antibiotics, sitz baths, and a second stitching once the inflammation has been treated, in order to heal properly.


Scars

# There is almost no scarring if the perineotomy is performed vertically, from the vagina to the anus, because it matches the grain of the tissue.
# The perineotomy incision is made at a 45-degree angle if an anal laceration is a concern. This leaves a little scar tissue that does not usually affect a patient's quality of life.
# Large scars that spread in multiple directions are aesthetically unpleasing and can cause pain during sex. Most scars can be removed or made more aesthetically pleasing with plastic surgery.


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