Clinical and Aesthetic Review of Episiotomy Wound Closure Methods.
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Abstract
An episiotomy is a surgical incision in the perineum to facilitate the baby's head during delivery. Physicians or midwives may use this procedure if he/she finds out the tissue around the vaginal opening begins tearing or does not seem to be stretching enough to allow the baby to be delivered. With an increasing trend for hospital births and for physicians to get involved in the normal uncomplicated birth process, there was rise in the number of episiotomies. After the baby is delivered through the extended vaginal opening, the area is applied with local anesthetic agent and incision is repaired with sutures. Our study reviewed the development in the past twenty years regarding episiotomy wound closure methods, and discovered that continuous sutures for episiotomy or perineal repair have clinical advantages in term of faster and better wound healing, more favorable scarring, shorter post-procedural pain, more rapid resumption of sexual activity, lower incidence of urinary incontinence, compared to interrupted sutures. They were also beneficial in term of less consumption of suture materials. In determining suture materials, clinicians should strongly consider the tear severity, tissue characteristics, as well as the desired aesthetic outcome.
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References
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