Dr. LaPorte, Thank you for your clear examples. I was taught to avoid the hymenal ring, as it causes long-term pain for women. What is your experience? Thanks, Leilani Hall
What about burying the final knot deeper in the vagina? I've found that sutures near the hymen or on the introitus cause significant pain and irritation during the healing process, many have to have the knots removed early due to severe discomfort.
I have not noted this issue. Now remember, that women who breast-feed have a high levels of prolactin which acts as an antiestrogen and produces atrophic vaginitis. The treatment is Premarin vaginal cream.
Kathleen, No, this video nor an article has been published - only placed on UA-cam.com. I have taught Perineal Repair as part of the ALSO (Advanced Life Support Obstetrics) course presented twice per year by the University of Minnesota Department of Family Medicine since about 2010. I realized that I was repeating myself each time so I hired a local wedding videographer to record the instructions. Now, I have the students view the video at home prior to the class and actually play the video on small computers at each workstation during the class. I then can assist individual students when they get stuck. I encourage students to take the yellow sponge home and continue to learn with the video support on UA-cam. You will note video four of the series - "Materials and Methods" - offers instructions on sponge prep and resources for equipment. My intent was to assist other instructors. Feel free to publish this information. I guess I am too lazy to publish as I am 72 years old.
This method is very quickly,but... 1)continuous suture worsens the blood supply to tissues.Separate interrupted sutures are better 2)The suture material in the tissues takes a long time to dissolve. This brings discomfort to women and worsens the consequences. The interrupted sutures are removed and the wound heals faster. 3)with continuous suturing, the risk of hematomas is higher
When u do this procedure, do you start closest to the vagina when starting or the opposite direction?, closest to the anus, or does it matter?? Asking for a friend who feels they did hers wrong 😇😇😇
This is the most helpful demonstration of laceration repair. It's even more clearer than practicing with my professors in person. Thank you!
thanks!! as a midwife working in india i needed clear concise instructions and an easy way to stitch!
ap please mere kuch doubts clear karoge
UA-cam took me to a weird place tonight. Anyways, your knot tying skills are great. Surgeons are impressive!
Thank you! This will be on repeat!
Sir,
Thanks - I hope you find it useful.
Vince
Very clear and useful. Thank you from Canada!
My mom was Canadian. Vince
Very informative! Thank you so much for this video! It really is a big help.
Vince
Dr. LaPorte,
Thank you for your clear examples. I was taught to avoid the hymenal ring, as it causes long-term pain for women. What is your experience?
Thanks,
Leilani Hall
this is a male obstetrician's repair... We do not do this as midwives. Listen to women always
I share Leilani Hall's question down below regarding avoiding the hymenal ring as it leads to long term discomfort for the mother. Could you respond?
Dear Ms Oxenham,
I am not aware of any data regarding long term pain - do you have any references or studies - I would like to know.
Thanks,
Vince
Thank you for uploading a clear video n u made it look very simple! :)
Sir can you put step by step doing the 2nd degree Perenial repair demonstration
Why didn't you tie the first knot at begging?
Ty u this is exactly what my teacher did
Do they give a location anesthetic when stitching?
I had a 3rd degree tear, had epidural onboard already.... would hate to know how it would have been without it...... XC
Ideally yes, but many public hospital just give 1 dose of lidocaine.
Thanks for more information
Great Demo. Thanks.
Joseph, Glad you found it useful. Fine cheap suture at esuture.com - best to phone and describe your request.
Haw much sitches are comes in this cases
How is an internal sulcus tear repaired? thanks!
Thank you!
What about burying the final knot deeper in the vagina? I've found that sutures near the hymen or on the introitus cause significant pain and irritation during the healing process, many have to have the knots removed early due to severe discomfort.
I have not noted this issue. Now remember, that women who breast-feed have a high levels of prolactin which acts as an antiestrogen and produces atrophic vaginitis. The treatment is Premarin vaginal cream.
Is there a video for a 1st degree Perineal Repair?
No, that is too simple.
Vince
sometimes they don't even repair those because the tear is just skin.
Has this been published in a journal?
Kathleen,
No, this video nor an article has been published - only placed on UA-cam.com. I have taught Perineal Repair as part of the ALSO (Advanced Life Support Obstetrics) course presented twice per year by the University of Minnesota Department of Family Medicine since about 2010. I realized that I was repeating myself each time so I hired a local wedding videographer to record the instructions. Now, I have the students view the video at home prior to the class and actually play the video on small computers at each workstation during the class. I then can assist individual students when they get stuck. I encourage students to take the yellow sponge home and continue to learn with the video support on UA-cam. You will note video four of the series - "Materials and Methods" - offers instructions on sponge prep and resources for equipment. My intent was to assist other instructors. Feel free to publish this information. I guess I am too lazy to publish as I am 72 years old.
perfect perfect perfect
This method is very quickly,but...
1)continuous suture worsens the blood supply to tissues.Separate interrupted sutures are better
2)The suture material in the tissues takes a long time to dissolve. This brings discomfort to women and worsens the consequences. The interrupted sutures are removed and the wound heals faster.
3)with continuous suturing, the risk of hematomas is higher
No, less than 25% need repairs.
Thanks,
Vince
no it repair very soon one week or after week
How long does this repair take on a patient? Thanks!
Morgan,
A typical second degree repair (no extensions) should take 15 - 20 minutes.
Vince
When u do this procedure, do you start closest to the vagina when starting or the opposite direction?, closest to the anus, or does it matter?? Asking for a friend who feels they did hers wrong 😇😇😇
Looks painful..
Stitches are so loose I wouldn’t want you sewing anybody up
Perineal swelling can be considerable in the first 24 hours - so just approximate with slight tension do not strangulate.