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Re: Episiotomy/laceration breakdown From: art fougner, md (evsono@pipeline.com) Mon Dec 19 10:57:43 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: Hospital sues physician, was Kick Counts" Previous message: ainsron: "Re: abortion" In reply to: Elrod Darryl G MAJ 48 MDOS/SGOBO: "Episiotomy/laceration breakdown" Next in thread: Efrain Ramirez: "Re: Episiotomy/laceration breakdown" Reply: Efrain Ramirez: "Re: Episiotomy/laceration breakdown" Glen check this article Am J Obstet Gynecol. 1992 Oct;167(4 Pt 1):1104-7. Early repair of episiotomy dehiscence associated with infection. Ramin SM, Ramus RM, Little BB, Gilstrap LC 3rd. Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas 75235-9032. OBJECTIVE: The purpose of our study was to examine early repair of episiotomy dehiscences in a large urban hospital setting serving a predominantly indigent population. STUDY DESIGN: Since September 1, 1989, we have proceeded with early repair in the immediate postpartum period. The medical records of 34 of 35 patients who underwent early repair were reviewed. RESULTS: Of the 34 patients, 21 (62%) had midline and 13 (38%) had mediolateral episiotomies. Dehiscence was associated with episiotomy infection in 27 (79%) of the 34 patients: 18 (86%) in the midline group and 9 (69%) in the mediolateral group. Repair was accomplished from 3 to 13 days (mean = 6.4) after dehiscence. Successful repairs were accomplished in 32 (94%) of 34 patients. Two (6%) patients with initial third-degree episiotomies had a subsequent breakdown of their repairs and were allowed to heal by secondary intention. CONCLUSIONS: Although most dehiscences in our population were associated with infection, early repair in this population is associated with a satisfactory outcome in the vast majority. Art At Mon, 19 Dec 2005, Elrod Darryl G MAJ 48 MDOS/SGOBO wrote: > >I'm seeing a patient today that is a week out from a vaginal delivery >with a 2nd degree laceration in the midline. The laceration site was >repaired with Vicryl in a normal fashion. The sutures have opened >causing the patient a fair bit of discomfort. This one is open from >just inside the hymen down to the perineal body area. > >Thankfully, broken down lacerations or episiotomies are few and far >between. I'm just curious what others do. Leave it to heal by >secondary intention? Close it now or close it in the near future? Wet >to dry dressing changes? Sitz baths? > >Thanks, > >Glen > >//SIGNED// > >D. Glen Elrod, Maj., USAF, MC > >Obstetrician/Gynecologist > >Chief of Obstetrics > >48 MDOS/SGOBO > >RAF Lakenheath, England > >Telephone DSN: 314-226-8130 > > Comm: +44 (0) 1638 52 8130 > >Notice of Confidentiality >Under the Privacy Act of 1974, you must safeguard all information >reflected on this e-mail and, if applicable, all attachments. >Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI >37-132, AFI 33-219, and PL 93-579" >This e-mail message including any attachments is for the sole use of the >intended recipient(s) and may contain confidential and privileged >information. Any unauthorized review, use, disclosure or distribution is >prohibited. If you are not the intended recipient, please contact the >sender by reply e-mail and destroy all copies of the original message. >Any questions pertaining to disclosure should be directed to the privacy >officer. -- art fougner, md "I knew I was going to take the wrong train, so I left early." Lawrence Peter Berra Next message: Efrain Ramirez: "Re: Hospital sues physician, was Kick Counts" Previous message: ainsron: "Re: abortion" In reply to: Elrod Darryl G MAJ 48 MDOS/SGOBO: "Episiotomy/laceration breakdown" Next in thread: Efrain Ramirez: "Re: Episiotomy/laceration breakdown" Reply: Efrain Ramirez: "Re: Episiotomy/laceration breakdown"

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