How to repair an episiotomy

摘要

Preparation and equipment Practitioners should be familiar with the perineal tissues and muscles involved in an episiotomy including the posterior vaginal wall, subcutaneous fat, perineal skin layer, superficial muscles (bulbocavernosus and transverse perinei) and deep muscle (pubococcygeus) (Figure 1). The practitioner should explain the procedure to the woman and gain informed verbal consent. The practitioner should check the woman's vital observations, per vaginum blood loss and that the uterus is well contracted. The woman should be in a comfortable position with her legs apart, ideally in a lithotomy position to improve visibility and access to the perineum during the procedure. The practitioner should ensure the necessary equipment is available, including: - An appropriate source of light. - Sterile gloves. - Sterile water or an antiseptic solution, depending on local policy. - A needle and syringe containing 1% lidocaine. - X-ray detectable swabs. - Sterile towels. - A vaginal tampon.