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Perineal repair videos

Discussion in 'Educational Media' started by Josie, Apr 5, 2010.

  1. loopyloulou

    loopyloulou Member

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    Oh my goodness, what a good result afterwards. I'm glad I've seen this as tears are one of my worries!
    Great to see what happens.
  2. Kizzi

    Kizzi Well-Known Member

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    I thought it would be worse than this, was really good to watch and have a better understanding!!
  3. La Sage-Femme

    La Sage-Femme Active Member

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    I'll admit I had to take the 2nd vid off 'full screen' as it was a bit too much close up!

    Really interesting though, thanks for posting x
  4. Dancing_Queen

    Dancing_Queen Member

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    I am much more squeamish than I thought, my skin was twitching more than than I expected lol - maybe it is because I have been stitched!! It was very fascinating and I am pleased I have seen it - just hope I don't freak out on placement!
  5. Shoshana

    Shoshana Member

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    This is a really good link. Thanks for finding and posting Bossdog and Josie. - It's amazing what you can find on the internet, isn't it? :eek:

    A few comments:

    I think the woman must have a very good working epidural or spinal, because she doesn't flinch once during the whole process! I tend to use local anaesthesia for suturing. Once the local is in the woman shouldn't feel pain, but can still feel touch. This can make the woman flinch.

    The set up in the video was quite "surgical". In reality, as a midwife I do wash my hands well, wear a gown and gloves. And yes, I do suture the woman's perineum in lethotomy. But, I don't have a massive theatre light. I don't have lots of drapes (only one under the woman's bottom and one on her abdomen.) I don't wear a mask. And I don't wash down with iodine. - Interestingly, the perineum in the second video hasn't been washed with iodine!

    The suture technique described is not the same as is shown in the video. - The written commentary states "Place three or four interrupted sutures into the muscle layer." - But this is not what happens in the video. I have been taught to do continuous sutures for the whole repair (which is shown in the video). It also states "Suturing the skin complete a sub-cuticular suture, beginning at the anal end and ending at the fourchette with a sub-cuticular knot" - In the video the skin is sutured from the fourchette, finishing at the other end and he passes the suture needle through the muscle of her buttock and cuts off! - I've never seen that done!

    This is an episiotomy - quite a large one - but a very straight forward one for suturing, which makes it ideal as a teaching video. I can tell that it's an epis by the angle - it is going away from the anal sphincter, towards the woman's right buttock. A tear will go straight down. Tears are not always that 'neat' and large tears can be harder to suture. It can sometimes be hard to work out which bit goes where, if you see what I mean! But, it is very satisfying when you finish the job and the woman is neatly 'put back together'! :)

    Yes, there can be quite a lot of tugging and prodding during suturing, which is why adequate analgesia is so important.

    I don't mean to sound too critical of the video. I do think it's a really good link and very helpful for those of you who have never been in that situation, in real life ..... yet!
  6. willowtree

    willowtree Member

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    yikes! i'm deep breathing... think it's the idea of having my foof pulled around like that. think i'll be ok if and when it comes to it, just take a bit of getting used to. what a very neat job though! she must have been drugged to the eyeballs to go through that!
  7. meanttobe

    meanttobe New Member

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    Shoshana - I'm glad you mentioned the disconnect between the written instruction and what was shown, I noticed that too. Esp. what it said about only using each swab once and then watching how the man in the video prepped so differently. There were a few other parts where I caught myself going "but that's not what they said!" It's right what you said though, good exposure either way - and I guess every protocol will be slightly diff regardless...
  8. Marshmellow

    Marshmellow Active Member

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    Hahaha! that made me giggle!
    Thanks shoshana for giving a bit more information!! x
  9. Lil Miss Sunshine

    Lil Miss Sunshine Well-Known Member

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    hmmm maybe i shouldn't have watched that before going to bed.... think i'm gona have nightmares! :-$
    Ahhh well it's all preparation, the 2nd video showed a good job eh considering the damage. I do feel a bit sick though lol, not seen one of those vids before!
    Thanks for sharing.... i'm gona go to bed now :D
    xxxx
  10. MonkeysMummy

    MonkeysMummy Active Member

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    interesting, didnt flinch like I thought I would :)

    hopefully I could manage to do it...

    How severe a tear would midwives repair?
    Would Drs do the bad tears or do midwives do them all?
    Sorry if thats a silly Q xx

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