Monday, May 27, 2024

REPAIRING OF EPISIOTOMY

Table of Contents

REQUIREMENTS #

  1. Suturing materials (Chronic cutgut)
  2. Sterile swabs
  3. Tampoule
  4. Vaginal pads
  5. Suture handle
  6. Suturing scissors
  7. Good light source
  8. Anaesthetic agent

STEPS #

  1. Establish rapport to mother (Refer steps)
  2. Explain procedure (Refer steps)
  3. Mobilize the necessary resources
  4. Help the woman lie on her back with her knee bent
  5. Position the woman’s buttocks at the edge of the bed or table. Her legs may be supported by stirrups or held up by an assistant
  6. Remove any soiled cloths from under her; then wash her genitals
  7. Help the woman void or insert a catheter to empty the bladder
  8. Scrub hands and put on sterile gloves
  9. Place a sterile or very clean towel or cloth under her buttocks. Place a tampon or gauze into the vagina if needed to keep blood off the area you are suturing
  10. Have an assistant evaluate vital signs every 15 minutes
  11. Have an assistant assess and massage the uterus, as necessary, during the procedure
  12. Fill a 10ml syringe with 1% lignocaine without epinephrine. If only 2% lignocaine available draw 5ml of sterile water and 5ml of lignocaine to make a 1% solution
  13. Pack the vagina with a gauze in order to prevent blood trailing into the wound
  14. Look carefully at the shape of the laceration and insert the needle point at the end or corner of the laceration
  15. Run it the length of the wound along the line where the suture needle will be either entering or exiting
  16. Pull back on the plunger of the syringe to check for blood and inject evenly as you withdraw the needle just below the skin
  17. Medication injection is stopped while the needle is redirected along another line of projected suturing, and the process is repeated until the entire are of possible pain is anesthetized
  18. Wait a minute or two to allow the medication to take effect before starting to sew the laceration
  19. Touch the laceration with the sharp point of a needle to make sure the anesthetic is working
  20. Start suturing if an anesthetic agent is working using the following technique