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Re: 4th degree tear/reconstructionFrom: Garry E. Siegel (garrys@mindspring.ocm)Sat Jun 17 17:29:23 2000
> >It was my opinion while in residency (and still is) (and the opinion of >one arrogant supervising resident - we did not agree on much else) - >that when repairing the vagina, rectovaginal septum and perineum after >delivery - the repair should be done with great care as a colporrhaphy >and perineorrhaphy. It should not be done as 'let's throw in some >stitches quick to get out of the delivery room fast'. > You are 1,000% correct; one of the junior Ob faculty when I was a senior student on an Ob sub-internship stressed that you should consider episiotomy/laceration repair as vaginal surgery--exactly as you said. That said, we sometimes do this in poor conditions, the LDR suite with light not as good as an OR, no suction, no assistant, sometimes suboptimal anesthesia (pudendal, local, or epidural that is worn off). When I get a 4th degree, I get appropriate anesthesia, extra light if needed, and ask a delivery nurse to "scrub in" if I think I need it. Garry
-- Garry E. Siegel, M.D., F.A.C.O.G. Private Practice Roswell, GA
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