2nd Degree Perineal Repair Demonstration

[@iceykargbo4028]

This is the most helpful demonstration of laceration repair. It's even more clearer than practicing with my professors in person. Thank you!

[@wintermoongoddess]

thanks!! as a midwife working in india i needed clear concise instructions and an easy way to stitch!

[@jyotilakshmi4443]

ap please mere kuch doubts clear karoge

[@christianpearls3725]

Thank you! This will be on repeat!

[@vdlaporte]

Sir, Thanks - I hope you find it useful. Vince

[@Widderic]

KZbin took me to a weird place tonight. Anyways, your knot tying skills are great. Surgeons are impressive!

[@leilanihall1345]

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

[@Lally75uk]

this is a male obstetrician's repair... We do not do this as midwives. Listen to women always

[@lambsouvlaki7272]

Very clear and useful. Thank you from Canada!

[@vdlaporte]

My mom was Canadian. Vince

[@vloc15]

Very informative! Thank you so much for this video! It really is a big help. Vince

[@lisamarieoxenham2945]

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?

[@vdlaporte]

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

[@shiltsze]

Thank you for uploading a clear video n u made it look very simple! :)

[@basoyangmichaelb.mid2a895]

Sir can you put step by step doing the 2nd degree Perenial repair demonstration

[@ericaliebenberg7844]

Do they give a location anesthetic when stitching?

[@ShiningSakura]

I had a 3rd degree tear, had epidural onboard already.... would hate to know how it would have been without it...... XC

[@PrinceMascara]

Ideally yes, but many public hospital just give 1 dose of lidocaine.

[@CaptainMorgan_10]

How is an internal sulcus tear repaired? thanks!

[@stellalagat766]

Why didn't you tie the first knot at begging?

[@sdfPZXC]

Ty u this is exactly what my teacher did

[@josephchang007]

Great Demo. Thanks.

[@vdlaporte]

Joseph, Glad you found it useful. Fine cheap suture at esuture.com - best to phone and describe your request.

[@kathleenmccarthy619]

Has this been published in a journal?

[@vdlaporte]

Kathleen, No, this video nor an article has been published - only placed on KZbin.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 KZbin. 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.

[@luisafranco764]

Is there a video for a 1st degree Perineal Repair?

[@vdlaporte]

No, that is too simple. Vince

[@user-js2is9qo2l]

sometimes they don't even repair those because the tear is just skin.

[@nighatkaramat1436]

Thanks for more information

[@sumannimmiwal2770]

Haw much sitches are comes in this cases

[@АндрейПрищепа-к5л]

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

[@tatianikaratsopanou9413]

Thank you!

[@amyb639]

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.

[@vdlaporte]

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.

[@CaptainMorgan_10]

How long does this repair take on a patient? Thanks!

[@vdlaporte]

Morgan, A typical second degree repair (no extensions) should take 15 - 20 minutes. Vince

[@vdlaporte]

No, less than 25% need repairs. Thanks, Vince

[@manhanoorlittledoll8763]

no it repair very soon one week or after week

[@Carribean_gurl]

Looks painful..

[@neginsarmadi2779]

perfect perfect perfect

[@joshsan66]

Stitches are so loose I wouldn’t want you sewing anybody up

[@vdlaporte]

Perineal swelling can be considerable in the first 24 hours - so just approximate with slight tension do not strangulate.

[@avikillozmusic]

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 😇😇😇