Episiotomy and how to care

Episiotomy is a surgical incision on the perineum at posterior wall of vagina during second stage of labour.

Aim

• To increase the vaginal introitus for easy and safe delivery of fetus.
• To minimise the overstretching and rupture of perineal muscle and fascia.
• To reduce strain on fetal head.

How to care for episiotomy

• Dressings should be done each time after urination and defecation.
• Antiseptic solution (Providone-iodine) can be used.
• Ice packs can reduce swelling.(Apply for 5-10 minutes).
• Mild analgesics as prescribed by physician can be used.
• Sitz bath(lukewarm water with betadine solution dilution) can be given in tub of water for 10-15 minutes and do not leave the mother unobserved as she may have hypotension.
• Early ambulation within 24 hours may help in wound healing and circulation and also rolling on side in bed is useful.

Care of Sutures

Most of the sutures are absorbable but if they are non absorbable are used the doctor may cut on 6th day post delivery.

Report to doctor immediately if

• There is extension of incision to anus or rectum on observation
• Pain(throbbing) on perineum.
• Vulval Hematoma
• Offensive discharge or pus at wound.
• Noticeable changes at suture site such as delayed healing, wound appears moist, swollen or inflammed.
• Rise in body temperature .