Episiotomy - Revision history

Danbot: Add peer-reviewed reference

2026-03-22T10:16:17Z

Add peer-reviewed reference

← Older revision		Revision as of 10:16, 22 March 2026
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	==Episiotomy==		==Episiotomy==
	*Midline episiotomy - easier to heal, less painful, but can extend to anus		*Midline episiotomy - easier to heal, less painful, but can extend to anus<ref>Jiang H, et al. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database Syst Rev. 2017;2:CD000081. PMID 28176333</ref>
	*Mediolateral - unlikely to extend to anus		*Mediolateral - unlikely to extend to anus
	*Anatomic structures - vaginal epithelium, transverse perineal muscle, bulbocavernosus muscle, perineal skin		*Anatomic structures - vaginal epithelium, transverse perineal muscle, bulbocavernosus muscle, perineal skin

2016-07-11T21:21:42Z

Text replacement - "don't" to "do not"

← Older revision		Revision as of 21:21, 11 July 2016
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	*Start an anchoring stitch at apex within vaginal mucosa		*Start an anchoring stitch at apex within vaginal mucosa
	*Continuous LOCKing sutures along vaginal mucosa/submucosa		*Continuous LOCKing sutures along vaginal mucosa/submucosa
	*Once at the hymen/perineal muscles, tie suture, but ~~don't~~ cut continuous end		*Once at the hymen/perineal muscles, tie suture, but do not cut continuous end
	*Bury the knot within the perineum, and come out with the needle at the apex of the perineum		*Bury the knot within the perineum, and come out with the needle at the apex of the perineum
	*Continue suturing perineal muscles up to skin in a NON-locking fashion		*Continue suturing perineal muscles up to skin in a NON-locking fashion

2016-06-26T08:06:30Z

Text replacement - "==Sources==" to "==References=="

← Older revision		Revision as of 08:06, 26 June 2016
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	*Bury knot in superficial perineum/subQ and cut remaining suture from needle		*Bury knot in superficial perineum/subQ and cut remaining suture from needle

	==~~Sources~~==		==References==
	*Lappen et al. Episiotomy and Repair Technique. Updated Feb 27, 2014. http://emedicine.medscape.com/article/2047173-technique#showall		*Lappen et al. Episiotomy and Repair Technique. Updated Feb 27, 2014. http://emedicine.medscape.com/article/2047173-technique#showall
	*American College of Obstetrics and Gynecology. Episiotomy. ACOG Practice Bulletin #71. Obstet Gynecol. 2006. 107:957-62.		*American College of Obstetrics and Gynecology. Episiotomy. ACOG Practice Bulletin #71. Obstet Gynecol. 2006. 107:957-62.

2016-03-22T14:21:29Z

2015-08-11T14:54:34Z

← Older revision		Revision as of 14:54, 11 August 2015
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	*American College of Obstetrics and Gynecology. Episiotomy. ACOG Practice Bulletin #71. Obstet Gynecol. 2006. 107:957-62.		*American College of Obstetrics and Gynecology. Episiotomy. ACOG Practice Bulletin #71. Obstet Gynecol. 2006. 107:957-62.
	*American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 120: use of prophylactic antibiotics in labor and delivery. Obstet Gynecol. 2011 Jun. 117(6):1472-83.		*American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 120: use of prophylactic antibiotics in labor and delivery. Obstet Gynecol. 2011 Jun. 117(6):1472-83.



			[[Category:OB/GYN]]

2015-08-11T14:53:13Z

← Older revision		Revision as of 14:53, 11 August 2015
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	==Sources==		==Sources==
	*Lappen et al. Episiotomy and Repair Technique. Updated Feb 27, 2014. http://emedicine.medscape.com/article/2047173-technique#showall		*Lappen et al. Episiotomy and Repair Technique. Updated Feb 27, 2014. http://emedicine.medscape.com/article/2047173-technique#showall
			*American College of Obstetrics and Gynecology. Episiotomy. ACOG Practice Bulletin #71. Obstet Gynecol. 2006. 107:957-62.
	*American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 120: use of prophylactic antibiotics in labor and delivery. Obstet Gynecol. 2011 Jun. 117(6):1472-83.		*American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 120: use of prophylactic antibiotics in labor and delivery. Obstet Gynecol. 2011 Jun. 117(6):1472-83.

2015-08-11T14:52:31Z

← Older revision		Revision as of 14:52, 11 August 2015
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	==Sources==		==Sources==
	*Lappen et al. Episiotomy and Repair Technique. Updated Feb 27, 2014. http://emedicine.medscape.com/article/2047173-technique#showall		*Lappen et al. Episiotomy and Repair Technique. Updated Feb 27, 2014. http://emedicine.medscape.com/article/2047173-technique#showall
			*American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 120: use of prophylactic antibiotics in labor and delivery. Obstet Gynecol. 2011 Jun. 117(6):1472-83.

2015-08-11T14:50:53Z

← Older revision		Revision as of 14:50, 11 August 2015
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	==Complications==		==Complications==
			*Bleeding
			*Extension to higher-odre lacerations
			*Infection - routine antibiotic prophylaxis not recommended by ACOG due to lack of evidence
			*Dehiscence

	==Repair==		==Repair==

2015-08-11T14:43:31Z

← Older revision		Revision as of 14:43, 11 August 2015
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	*Once at the hymen/perineal muscles, tie suture, but don't cut continuous end		*Once at the hymen/perineal muscles, tie suture, but don't cut continuous end
	*Bury the knot within the perineum, and come out with the needle at the apex of the perineum		*Bury the knot within the perineum, and come out with the needle at the apex of the perineum
	*Continue suturing up to skin in a NON-locking fashion		*Continue suturing perineal muscles up to skin in a NON-locking fashion
	*At apex of skin, perform dermal approximations down to distal skin edge		*At apex of skin, perform dermal approximations down to distal skin edge
	*Return to apex of skin with a subcuticular stitch (like a monocryl skin closure) and tie knot		*Return to apex of skin with a subcuticular stitch (like a monocryl skin closure) and tie knot

2015-08-11T14:42:49Z

Repair

← Older revision		Revision as of 14:42, 11 August 2015
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	==Repair==		==Repair==
	*Examine 360 degrees for other non-hemostatic lacerations that require sutures		*Examine 360 degrees for other non-hemostatic lacerations that require sutures
	*Use 2-0 or 3-0 vicryl rapide or similar		*Use 2-0 or 3-0 vicryl rapide or similar - the same suture will be used to close all tissue
	*Start an anchoring stitch ~~1 cm above~~ apex within vaginal mucosa		*Start an anchoring stitch at apex within vaginal mucosa
	*Continuous ~~locking~~ sutures along vaginal mucosa/submucosa		*Continuous LOCKing sutures along vaginal mucosa/submucosa
	*Once at the hymen/perineal muscles, tie suture, but don't cut continuous end		*Once at the hymen/perineal muscles, tie suture, but don't cut continuous end
	*Bury the knot within the perineum		*Bury the knot within the perineum, and come out with the needle at the apex of the perineum
			*Continue suturing up to skin in a NON-locking fashion
			*At apex of skin, perform dermal approximations down to distal skin edge
			*Return to apex of skin with a subcuticular stitch (like a monocryl skin closure) and tie knot
			*Bury knot in superficial perineum/subQ and cut remaining suture from needle

	==Sources==		==Sources==
	*Lappen et al. Episiotomy and Repair Technique. Updated Feb 27, 2014. http://emedicine.medscape.com/article/2047173-technique#showall		*Lappen et al. Episiotomy and Repair Technique. Updated Feb 27, 2014. http://emedicine.medscape.com/article/2047173-technique#showall