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Home Books Williams Obstetrics, 25e. Previous Chapter. Next Chapter. Cunningham F, Leveno K.
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Gary Cunningham, et al. Accessed September 23, Sometimes, however, stitches have to be removed by the doctor or midwife. A small number of perineal wounds come open break down or have delayed healing, and some of these may need to be re-stitched. This review includes 18 randomised controlled trials with 10, women and looks at catgut and synthetic materials used to stitch the perineum after childbirth. It also includes a more recently produced material which has been specially designed to be absorbed more quickly. The main findings were that women stitched with synthetic materials had less pain in the first three days after delivery and needed fewer drugs to relieve pain in the 10 days after giving birth, compared with women stitched with catgut.
There was evidence that synthetic stitches were not always readily absorbed and some women with these stitches needed them to be removed. Women experienced similar short and long-term pain with standard absorbable synthetic materials and more rapidly absorbing stitches.
However, in one trial , fewer women with rapidly absorbing stitches reported using pain-relieving drugs during the 10 days after delivery, and there was less need for these stitches to be removed. When catgut and glycerol-impregnated catgut were compared the results were similar, although the latter was associated with more short-term pain. One trial examined monofilament and standard synthetic stitches and there was little difference between the two materials in terms of pain and wound healing.
As well as the type of material used, other factors such as the technique used to carry out the stitching using a continuous thread or a series of separately tied stitches and the skill of the person carrying out the procedure, may also affect the amount of pain and the way perineal wounds heal. Catgut may increase short-term pain compared with synthetic sutures.
Third and fourth degree lacerations after vaginal delivery
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Product No. Find your local Distributor. A staged training system for teaching 1 Episiotomy: a simplified model for teaching safe methods of episiotomy 2 Perineal Repair Techniques: the episiotomy and perineal repair pad prompts trainees to learn to suture on 2 plans, one which has spatial challenges which exist when suturing within the vagina. Features Skills Contains Downloads Features. Anatomy Realistic Perineal skin Realistic superficial muscle structure and relevant layers for suturing.
Vaginal Delivery | Williams Obstetrics, 25e | AccessMedicine | McGraw-Hill Medical
Perineal Repair Perineum Product No. Carry case.