EPISIOTOMIA Y EPISIORRAFIA. Insición que se practica a nivel perineal, con. el objetivo de ampliar el canal vaginal y facilitar. la salida del. Siempre lo primero que se realiza es ubicar el ángulo de anclaje, ahí se realiza un primer punto en “X”. REPASO: ¿Qué músculos se. epiplocele epipodite episclera episclerite episiorrafia episiotomia episodio episodio dirigetto episodio doloroso.
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Perineal Laceration RepairEpisiotomy Repair.
Perineal Laceration Repair
These images are a random sampling from a Bing search on the term “Perineal Laceration Repair. Search Bing for all related images. Started inthis collection now contains interlinked topic pages divided into a tree of 31 specialty episiorrafua and chapters. Content is updated monthly with systematic literature reviews and conferences. Although access to this website is not restricted, the information found here is intended for use by medical providers.
Patients should address specific medical concerns with their physicians. Page Contents Page Contents Precautions Grading of perineal Lacerations Preparation Management: Vaginal Laceration Repair Management: Perineal muscle repair Management: External anal sphincter repair Management: Rectal mucosa and internal sphincter repair Management: Perineal skin repair Complications References Extra: Related Bing Images Extra: Vaginal Laceration Repair Description Closure of vaginal mucosa behind hymenal ring Vaginal tears may involve both sides of vaginal floor Gene ral Indicated in first through fourth degree Laceration s Repaired with Vicryl on CT-1 needle Anchor Suture 1 cm above apex of vaginal Laceration Use Running stitch continuous to close vaginal mucosa Locking Suture is optional used for hemostasis Each pass should include Vaginal mucosa Rectovaginal fascia important for vaginal support Continue Running Suture up to hymenal ring May be tied off proximal to hymenal ring or May be passed under hymenal ring to perineum May be used for closing perineal skin see below.
Perineal muscle repair Description Bulbocavernosus and transverse perineal muscle closed Gene ral Indicated in second through fourth degree Laceration s Repaired with Vicryl on CT-1 needle Close each muscle body with interrupted figure 8 Suture Closure of bulbocavernosus muscle Located immediately below introitus Located above transverse perineal muscle Closure of transverse perineal muscle Located above external anal sphincter.
External anal sphincter repair Description Closure of external anal sphincter Gene ral Indicated in third and fourth degree Laceration s Repaired with Polydioxanone PDS on CT-1 needle Identify external anal sphincter ends Clamp each external anal sphincter muscle Must include rectal sphincter sheath capsule Must be included in closure for adequate strength Close external anal sphincter Option 1: End to end external anal sphincter closure Standard epidiotomia, but may be replaced by Option 2 Associated with poorer functional outcomes Kammerer-Doak Am J Obstet Gynecol Overlapping external anal sphincter closure May be preferred method due to better outcomes Overlap each end of external anal sphincter Allow sufficient overlap to place 3 Suture s Place 3 mattress Suture s through overlapped edges Pass Epiisorrafia through eepisiotomia end and inferior end Pass Suture through inferior, then superior end Tie at top overlying superior sphincter edge.
Rectal mucosa and internal sphincter repair Description Closure of rectal mucosa Closure of internal anal sphincter Gene ral Indicated in fourth degree Laceration s Closed with Vicryl on SH needle Gelpi retractor used to maximize visualization Episioomia rectal mucosa with Running Suture Start at apex of rectal mucosal tear Keep Suture passes episiorrafiaa spaced Do not Suture complete thickness of rectal mucosa Risk of anal fistula formation Continue Suture to anal verge on perineal skin Close internal anal sphincter Allis clamp placed at each end epiaiotomia internal sphincter Close internal anal sphincter with PDS Perineal skin episiorrafi Description Bulbocavernosus and transverse perineal muscle closed Gene ral Indicated in first through fourth degree Laceration s Closure of perineal skin is controversial May be associated with higher rate perineal pain Gordon Br J Obstet Gynaecol Complications Chronic perineal pain including Dyspareunia Associated with perineal skin closure Urinary and Fecal Incontinence Associated with third and fourth degree tears Anal Fissure Associated with fourth degree tears.
References Leeman Am Fam Physician Related links to external sites from Bing. Repair of episiotomy C Related Topics in Procedure.
Aula prática de episiotomia e episiorrafia
Obstetrics – Procedure Pages. Back Links pages that link to this page.
Episiorratia other sites for ‘Perineal Laceration Repair’. Therapeutic or Preventive Procedure T Episiotomy with repairepisioplastyepisiorrhaphyRepair of episiotomyEpisiorrhaphy procedureepisiotomy repairepisiotomy repair treatmentEpisiorrhaphySuturing of episiotomyRepair of episiotomy procedureEpisiorrhaphy procedure [Ambiguous]Repair;episiotomy.