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Perineal Laceration Repair

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1. Perineal Laceration Repair

Perineal Laceration Repair Perineal Laceration Repair Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Perineal Laceration Repair (...) Perineal Laceration Repair Aka: Perineal Laceration Repair , Episiotomy Repair II. Precautions Routine episiotomy offers no maternal benefits Limit use to fetal indications III. Grading of perineal Lacerations First degree Vaginal Perineal skin torn Second degree First degree and Perineal muscles torn Third degree Second degree and External anal sphincter torn Fourth degree Third degree and Complete anal sphincter tear and Rectal mucosa may also be torn IV. Preparation Polyglactin 910 ( ) 3-0 on CT-1

2018 FP Notebook

2. Do unsutured second-degree perineal lacerations affect postpartum functional outcomes?

Do unsutured second-degree perineal lacerations affect postpartum functional outcomes? Do unsutured second-degree perineal lacerations affect postpartum functional outcomes? – Less Is More Search for: Simpler & Better Medicine Menu / Summary: For women sustaining second-degree perineal lacerations during delivery, an approach of not repairing the second-degree laceration may be associated with a decreased need for post-partum pain medication in hospital compared to an approach of suturing (...) the second-degree laceration, without any increase in adverse long-term outcomes. Strength of Recommendation = B Advertisements Like this: Like Loading... Categories: Tags: Post navigation Simpler, Better Medicine Indexing evidence for "less medical” approaches with better outcomes. Recent entries Search by key words Search for: Search By Strength of Recommendation (SOR) (42) (244) (27) Search by clinical category For regular updates, follow "Less-Is-More" by Email, RSS, or on Wordpress Follow DISCLAIMER

2016 Less Is More Blog

3. Investigating the Efficacy of Anatomical Silicone Models Developed from a 3D Printed Mold for Perineal Repair Suturing Simulation (PubMed)

Investigating the Efficacy of Anatomical Silicone Models Developed from a 3D Printed Mold for Perineal Repair Suturing Simulation There is a scarcity of affordable, validated, standardized and anatomically correct silicone perineum models for the rehearsal of postpartum laceration repair. The purpose of this technical report is to describe and validate evidence for a silicone, perineal repair model created from a 3D printed mold for medical resident training and clinical skills maintenance (...) a postpartum repair. There were also suggestions to alter the colour of the model to be flesh-toned as opposed to pink, to more accurately simulate human tissue. Silicone perineum models, created from a 3D printed mold, are an economical training tool as compared to commercially available, cost prohibitive models. They also provide anatomically accurate simulation training opportunities for residents to learn and maintain clinical skills in perineal repair, as compared to beef tongues and synthetic sponges

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2018 Cureus

4. Prospective Evaluation of Topical Analgesia for Laceration Repair in the Emergency Department

Prospective Evaluation of Topical Analgesia for Laceration Repair in the Emergency Department Prospective Evaluation of Topical Analgesia for Laceration Repair in the Emergency Department - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one (...) or more studies before adding more. Prospective Evaluation of Topical Analgesia for Laceration Repair in the Emergency Department The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03071601 Recruitment Status : Recruiting

2017 Clinical Trials

5. Use of the Modified Beef Tongue Model for Teaching Repair of Obstetrical Fourth-Degree Laceration to Residents

workshop using the modified beef tongue model. Primary outcome will be measured as change in technical skills score as measured by change from baseline on a validated objective structured assessment of technical skills (OSTATS) for repair of fourth-degree laceration. Condition or disease Intervention/treatment Phase Fourth Degree Perineal Laceration Involving Anal Mucosa Obstetric; Injury Obstetric Labor Complications Other: Instructional video Other: Instructional workshop Not Applicable Study Design (...) Use of the Modified Beef Tongue Model for Teaching Repair of Obstetrical Fourth-Degree Laceration to Residents Use of the Modified Beef Tongue Model for Teaching Repair of Obstetrical Fourth-Degree Laceration to Residents - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved

2017 Clinical Trials

6. Rapidly Absorbing Polyglactin 910 Versus Monocryl for Laceration Repair

Information provided by (Responsible Party): Virginia Commonwealth University Study Details Study Description Go to Brief Summary: To evaluate the rates of dyspareunia with rapidly absorbing polyglactin 910 compared to monocryl using a validated sexual function questionnaire. To assess maternal satisfaction with the laceration repair and suture material. To assess overall perineal pain using a visual analog scale. To assess the rate of wound breakdown and the need for suture removal. Condition or disease (...) Intervention/treatment Phase Dyspareunia Perineal Tear Sutured Laceration Procedure: Laceration Repair with Polyglactic 910 Procedure: Laceration Repair with Monocryl Not Applicable Detailed Description: This randomized controlled trial will be conducted and VCU medical center comparing 2 types of suture: rapid polyglactin 910 (Vicryl Rapide) and monofilament (Monocryl) for first and second-degree lacerations or uncomplicated episiotomies requiring suture repair. Patients will be enrolled in the study

2017 Clinical Trials

7. Perineal care

in external facilities. CS: caesarean section, FGM: female genital mutilation, HHS: Hospital and Health Service, kg: kilogram, mmHg: millimetre of mercury, OASIS: obstetric anal sphincter injuries, OP: occipto-posterior position, >: greater than, <: less than Queensland Clinical Guideline: Perineal care Refer to online version, destroy printed copies after use Page 4 of 39 Flow Chart: Perineal assessment and repair Queensland Clinical Guidelines: F18.30-2-V3-R23 · Ensure privacy · Seek consent prior (...) Note detection of IAS Trauma identified? Repair not required · Classify injury · Use repair technique appropriate for injury · Use local and/or regional anaesthesia as appropriate Yes General principles for perineal assessment and repair · If haemostasis evident and structures apposed, suturing not required · Repair skin with continuous subcuticular sutures or consider surgical glue · Avoid large volumes of local anaesthetic for clitoral tears First degree repair · Repair muscle with continuous

2018 Queensland Health

8. Management of Third- and Fourth-degree Perineal Tears

knots beneath the superficial perineal muscles is recommended to minimise the risk of knot and suture migration to the skin. Surgical competence Who should repair obstetric anal sphincter injury? Obstetric anal sphincter repair should be performed by appropriately trained practitioners. Formal training in anal sphincter repair techniques should be an essential component of obstetric training. Postoperative management How should women with obstetric anal sphincter injury be managed postoperatively (...) to be an increase in the detection of anal sphincter injuries. 1 A trend towards an increasing incidence of third- or fourth-degree perineal tears does not necessarily indicate poor quality care. It may indicate, at least in the short term, an improved quality of care through better detection and reporting. 3 Obstetricians who are appropriately trained are more likely to provide a consistent, high standard of anal sphincter repair and contribute to reducing the extent of morbidity and litigation associated

2015 Royal College of Obstetricians and Gynaecologists

9. Perineal Laceration Repair

Perineal Laceration Repair Perineal Laceration Repair Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Perineal Laceration Repair (...) Perineal Laceration Repair Aka: Perineal Laceration Repair , Episiotomy Repair II. Precautions Routine episiotomy offers no maternal benefits Limit use to fetal indications III. Grading of perineal Lacerations First degree Vaginal Perineal skin torn Second degree First degree and Perineal muscles torn Third degree Second degree and External anal sphincter torn Fourth degree Third degree and Complete anal sphincter tear and Rectal mucosa may also be torn IV. Preparation Polyglactin 910 ( ) 3-0 on CT-1

2015 FP Notebook

10. ACOG Practice Bulletin No. 198: Prevention and Management of Obstetric Lacerations at Vaginal Delivery. (PubMed)

ACOG Practice Bulletin No. 198: Prevention and Management of Obstetric Lacerations at Vaginal Delivery. Lacerations are common after vaginal birth. Trauma can occur on the cervix, vagina, and vulva, including the labial, periclitoral, and periurethral regions, and the perineum. Most of these lacerations do not result in adverse functional outcomes. Severe perineal lacerations, extending into or through the anal sphincter complex, although less frequent, are more commonly associated (...) with increased risk of pelvic floor injury, fecal and urinary incontinence, pain, and sexual dysfunction with symptoms that may persist or be present many years after giving birth. The purpose of this document is to provide evidence-based guidelines for the prevention, identification, and repair of obstetric lacerations and for episiotomy.

2018 Obstetrics and Gynecology

11. ACOG Practice Bulletin No. 198 Summary: Prevention and Management of Obstetric Lacerations at Vaginal Delivery. (PubMed)

ACOG Practice Bulletin No. 198 Summary: Prevention and Management of Obstetric Lacerations at Vaginal Delivery. Lacerations are common after vaginal birth. Trauma can occur on the cervix, vagina, and vulva, including the labial, periclitoral, and periurethral regions, and the perineum. Most of these lacerations do not result in adverse functional outcomes. Severe perineal lacerations, extending into or through the anal sphincter complex, although less frequent, are more commonly associated (...) with increased risk of pelvic floor injury, fecal and urinary incontinence, pain, and sexual dysfunction with symptoms that may persist or be present many years after giving birth. The purpose of this document is to provide evidence-based guidelines for the prevention, identification, and repair of obstetric lacerations and for episiotomy.

2018 Obstetrics and Gynecology

12. Perineal Local Infiltration Study

Centre Study Details Study Description Go to Brief Summary: The prevalence of birth canal lacerations is more than 70% of all deliveries in Canada. The repair of such lacerations is usually done using a pre-existing epidural analgesia. Once the analgesic effect of the epidural analgesia fades, the laceration may cause intolerable pain, and result in emotional stress, difficulties in ambulation and breastfeeding, and more. The research team hypothesis is that adding a locally injected analgesic, which (...) will take effect once the epidural analgesia fades, may alleviate perineal pain, prevent such difficulties, and improve women's overall well-being and satisfaction. The proposed trial is a three-arm, single-masked, randomized trial. Women with a working epidural analgesia, and a laceration will be invited to participate. Women in the local anesthesia (LA) arm will get a LA injected to the laceration, women in the saline arm will get physiologic water injected to the laceration in order to mimic

2018 Clinical Trials

13. Nurse-midwives' ability to diagnose acute third- and fourth-degree obstetric lacerations in western Kenya. (PubMed)

Nurse-midwives' ability to diagnose acute third- and fourth-degree obstetric lacerations in western Kenya. Obstetric fistula devastates the lives of women and is found most commonly among the poor in resource-limited settings. Unrepaired third- and fourth-degree perineal lacerations have been shown to be the source of approximately one-third of the fistula burden in fistula camps in Kenya. In this study, we assessed potential barriers to accurate identification by Kenyan nurse-midwives (...) of these complex perineal lacerations in postpartum women.Nurse-midwife trainers from each of the seven sub-counties of Siaya County, Kenya were assessed in their ability to accurately identify obstetric lacerations and anatomical structures of the perineum, using a pictorial assessment tool. Referral pathways, follow-up mechanisms, and barriers to assessing obstetric lacerations were evaluated.Twenty-two nurse-midwife trainers were assessed. Four of the 22 (18.2%) reported ever receiving formal training

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2017 BMC Pregnancy and Childbirth

14. Efficacy of Extended-Release Liposomal Bupivacaine for Post-Partum Pain Management Following Obstetrical Laceration

and Interventions Go to Arm Intervention/treatment Experimental: Liposomal bupivacaine treatment group 20cc of liposomal bupivacaine will be injected into the vaginal/perineal laceration site, in subjects in the experimental arm, following completion of the surgical repair. Drug: Bupivacaine Liposome Injectable Product 20cc of liposomal bupivacaine will be injected into the vaginal/perineal laceration site, once, following completion of the surgical repair. Other Name: Exparel Active Comparator: 0.25% plain (...) bupivacaine treatment group 20cc of 0.25% plain bupivacaine will be injected into the vaginal/perineal laceration site, in subjects in the active comparator arm, following completion of the surgical repair. Drug: 0.25% plain bupivacaine 20cc of 0.25% plain bupivacaine will be injected into the vaginal/perineal laceration site, once, following completion of the surgical repair. Outcome Measures Go to Primary Outcome Measures : Change in postpartum pain control following repair of a second, third, or fourth

2017 Clinical Trials

15. Promoting Optimal Healing After Laceration Repair Study

Procedure: Closing perineal skin with surgical glue Procedure: No suturing of the perineal skin Not Applicable Detailed Description: At the University of Michigan, there are currently two standard techniques for repairing second-degree perineal lacerations that differ only in management of the perineal skin : Closure of the deep tissues and superficial perineal skin using a continuous 3-0 Vicryl suture Closure of the deep tissues with a continuous 3-0 Vicryl suture and reapproximation of, but not suture (...) -closure of the perineal skin. The primary goal of our study is to compare patient pain amongst the following three perineal skin repair techniques after second degree laceration: Perineal skin closure with suturing Not suturing the perineal skin Closure of the perineal skin with n-Butyl 2-cyanoacrylate (Indermil®) surgical glue. In all women, the deep vaginal and perineal tissues will be closed using a continuous 3-0 Vicryl suture, as is current standard practice. Aim: To assess and compare patient

2014 Clinical Trials

16. Using adhesive glue to repair first degree perineal tears: a prospective randomized controlled trial. (PubMed)

Using adhesive glue to repair first degree perineal tears: a prospective randomized controlled trial. Our objective was to evaluate the effectiveness of adhesive glue in repairing first degree perineal tears. We conducted a noninferiority prospective, randomized, controlled trial comparing adhesive glue with traditional suturing. Each case was evaluated immediately after birth and after the puerperium. The two-sample t-test and the Mann-Whitney nonparametric test were applied to compare (...) approach for the repair of common postpartum first degree lacerations. The use of adhesive glue achieves cosmetic and functional results equal to traditional suturing and offers some immediate advantages for the patient. While further clinical trials are needed to validate our results, it is important to inform obstetrician of the possible use of adhesive glue in these very common clinical scenarios. This trial is registered with NCT00746707.

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2014 BioMed research international Controlled trial quality: uncertain

17. Practice Bulletin No. 165 Summary: Prevention and Management of Obstetric Lacerations at Vaginal Delivery. (PubMed)

Practice Bulletin No. 165 Summary: Prevention and Management of Obstetric Lacerations at Vaginal Delivery. Lacerations are common after vaginal birth. Trauma can occur on the cervix, vagina, and vulva, including the labial, periclitoral, and periurethral regions, and the perineum. Most of these lacerations do not result in adverse functional outcomes. Severe perineal lacerations, extending into or through the anal sphincter complex, although less frequent, are more commonly associated (...) with increased risk of pelvic floor injury, fecal and urinary incontinence, pain, and sexual dysfunction with symptoms that may persist or be present many years after giving birth. The purpose of this document is to provide evidence-based guidelines for the prevention, identification, and repair of obstetric lacerations and for episiotomy.

2016 Obstetrics and Gynecology

18. Practice Bulletin No. 165: Prevention and Management of Obstetric Lacerations at Vaginal Delivery. (PubMed)

Practice Bulletin No. 165: Prevention and Management of Obstetric Lacerations at Vaginal Delivery. Lacerations are common after vaginal birth. Trauma can occur on the cervix, vagina, and vulva, including the labial, periclitoral, and periurethral regions, and the perineum. Most of these lacerations do not result in adverse functional outcomes. Severe perineal lacerations, extending into or through the anal sphincter complex, although less frequent, are more commonly associated with increased (...) risk of pelvic floor injury, fecal and urinary incontinence, pain, and sexual dysfunction with symptoms that may persist or be present many years after giving birth. The purpose of this document is to provide evidence-based guidelines for the prevention, identification, and repair of obstetric lacerations and for episiotomy.

2016 Obstetrics and Gynecology

19. Comparison Between Rectal Suppository Acetaminophen and Diclofenac Sodium as Analgesia for Postpartum Perineal Tear

or disease Intervention/treatment Phase Perineal Tear Perineal Laceration (Obstetric) Drug: Diclofenac Sodium 50Mg Suppository Drug: Paracetamol 500Mg Suppository Phase 2 Detailed Description: Studies has demonstrated that non-steroidal anti-inflammatory drugs (NSAIDs) rectal suppositories are associated with less pain up to 24 hours after birth, and less additional analgesia is required. Therefore, In view of rectal route of analgesic administration is better in local action and systemic paracetamol (...) Comparison Between Rectal Suppository Acetaminophen and Diclofenac Sodium as Analgesia for Postpartum Perineal Tear Comparison Between Rectal Suppository Acetaminophen and Diclofenac Sodium as Analgesia for Postpartum Perineal Tear - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number

2016 Clinical Trials

20. [Management of third and fourth degree perineal tears: A systematic review]. (PubMed)

[Management of third and fourth degree perineal tears: A systematic review]. This was a comprehensive literature review using Pubmed, Medline, Embase and Cochrane, whose aim was to analyse the prevalence of anal sphincter injuries, their risk factors, their management and their functional prognosis. The prevalence of 3rd and 4th degree perineal tears varies between studies from 2.95% regardless the parity to 25% in nulliparous women. Twenty-eight percent to 48% of these lacerations were (...) clinically occult. Perineal tears were associated with (multivariate analysis) forceps (6.021 [IC 95% 1.23-19.45]), nulliparity (OR 9.8 [IC 95% 3.6-26.2]), gestational age over 42 SA (OR 2.5 [IC 95% 1-6.2]), fundal pressure (OR 4.6 [IC 95% 2.3-7.9]), midline episiotomy (OR 5.5 [IC 95% 1.4-18.7]) or fetal weight in interval of 250g (OR 1.3 [IC 95% 1.1-1.6]). There was no difference between the sphincter repair techniques. Post-partum laxative use showed less painful bowel motion and earlier postnatal

2015 Journal de gynecologie, obstetrique et biologie de la reproduction

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