IV.

SURGICAL MANAGEMENT

SURGICAL INDICATION RESULT NURSING MANAGEMENT

PROCEDURE
PREOPERATIVE
Perineal The patient Sutures were ASSESSMENT:

Laceration went in normal applied. a) Note type of

Repair labor and laceration.

delivered a b) Note type of suture

baby boy. She to be used and

sustained number.

second-degree c) Inspect perineal

perineal area thoroughly. To

laceration. evaluate
hemostasis,
anatomic distortion,

Second-degree and anal sphincter

perineal integrity.

laceration PREOPERATIVE
MANAGEMENT:
involves the
d) Check extent of
perineal
perineal trauma –
muscles but
perform per vaginal
not involving
and per rectal
the anal
examination.
sphincter.
e) Check equipment--
suture packs and
A second-
materials needed.
degree
f) If needed, ensure
laceration is a
that appropriate
common tear
supervision/support
that can
is available prior to
happen
commencing the
while delivering repair.
a baby. These g) Ensure there is
tears adequate lightning.
go through the h) Notify the doctor if
skin into the the patient is
muscles sensitive to or are
underneath the allergic to any
vagina. Second medications, iodine,
degree latex, tape, and
lacerations anesthetic agents
need sutures. (local and general).
The i) Ensure that the
sutures will wound is adequately
help to hold the anesthetized.
edges of the
tear together to INTRAOPERATIVE
allow it to heal. MANAGEMENT:

The sutures j) Assist in the

will procedure, handling

dissolve on materials/equipment.

their own in a k) Check the finished

few repair if it is

weeks. anatomically correct.

l) Check swabs and
instruments after the
procedure.
m) Complete
documentation.

POSTOPERATIVE
 MANAGEMENT:
a) Offer ice bag to
perineum in 1st to 12
hours
b) Offer donut pillow.
c) Administer
analgesics PRN per
doctor’s order.
d) Administer stool
softener/laxative to
prevent fear from
tearing suture during
bowel movement
and help soften
stools and ease
pain.
e) Encourage use of
Sitz bath or perineal
shower.
f) Continue to evaluate
whether lochia is
pooling.
g) Continue perineal
assessment, assess
the rectal area for
the presence of
hemorrhoids. If any
are present,
document their
number,
appearance, and
 size in
centimeters.

REFERENCES:
Michigan Medicine. (June, 23, 2012). Second Degree Laceration.
https://www.med.umich.edu/1libr/HealthyHealing/Laceration-SecondDegree

Healthwise. (October 8, 2020). Episiotomy and Perineal Tears.

https://www.uofmhealth.org/health-library/zx3823

Allen, A. (September 14, 2016). Diagnosis and Repair 2nd Degree Tears And
Episiotomy. https://slideplayer.com/slide/9209122/

Lynch, D. (September 13, 2018). Intrapartum Nursing Care.

https://slideplayer.com/slide/12439530/