AICOG 2023 CPT - Dr. rashmi Ranjan Dash.pptx

complete perineal tear diagnosis and management is of paramount importance to prevent future complication like anal incontinence ,
right method , material and proper technique is the key

1. www.aicog2023.com D r. Rashmi Ranjan Dash MBBS, MS (O &G) Director & consultant – NAMAH HOSPITAL , Bhubaneswar Specialisation - Urogynecologist & Laparoscopic Surgeon COMPLETE PERINEAL TEAR REPAIR

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4. www.aicog2023.com Dear obstetricians use your finger not only for vote but diagnosis of OASI also (OASI – obstetrics anal sphincter injury)

5. www.aicog2023.com OUTLINE OF MANAGEMENT Rectal mucosa repair – vicryl 2-0 / 3-0 Internal anal sphincter repair – PDS 2-0/3-0 mattress suture External anal sphincter repair – end to end or overlap / PDS 2-0 / 3-0 Vaginal mucosa repair – vicryl 2-0 or rapid vicryl 2-0 Muscle closure Skin closure – mattresss / subcuticular

6. www.aicog2023.com IDENTIFICATION OF ANAL SPHINCTER Internal sphincter – it is lies between ext sphincter and rectal wall , fish meat like pale coloured External sphincter – Peri anal fat Finger lift test Horizontal direction of muscle Red meat appearance

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