Evaluation of the angled Episcissors-60® episiotomy scissors in spontaneous vaginal deliveries

Rajnish P Patel,1,2 Sunita M Ubale21Suyog Women's Hospital, 2Rajiv Gandhi Medical College, Thane, IndiaBackground: Obstetric anal sphincter injuries (OASIs) are the leading cause of anal incontinence in women. Episiotomies with a postdelivery suture angle of less than 30° to the mid...

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Autores principales:	Patel RP, Ubale SM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/92f611da9f0c411a8e207ec45f4f0609
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spelling	oai:doaj.org-article:92f611da9f0c411a8e207ec45f4f06092021-12-02T00:29:56ZEvaluation of the angled Episcissors-60® episiotomy scissors in spontaneous vaginal deliveries1179-1470https://doaj.org/article/92f611da9f0c411a8e207ec45f4f06092014-07-01T00:00:00Zhttp://www.dovepress.com/evaluation-of-the-angled-episcissors-60reg-episiotomy-scissors-in-spon-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470 Rajnish P Patel,1,2 Sunita M Ubale21Suyog Women's Hospital, 2Rajiv Gandhi Medical College, Thane, IndiaBackground: Obstetric anal sphincter injuries (OASIs) are the leading cause of anal incontinence in women. Episiotomies with a postdelivery suture angle of less than 30° to the midline are more likely to injure the anal sphincter directly, while those with a suture angle of more than 60° are associated with increased incidence of OASIs, as they do not relieve the pressure on the perineum. A safe zone of 40°–60° has been proposed. Recently, two new types of episiotomy scissors (Episcissors-60® Straight version and angled version) were introduced to ensure a standardized cutting angle of 60° to the midline. We audited our results with the angled Episcissors-60 in spontaneous vaginal deliveries. Materials and methods: Consecutive patients delivering in two private maternity hospitals in Thane, India undergoing clinically indicated episiotomies were included. Only patients delivering spontaneously were included. The scissors were introduced vaginally at crowning, and aligned to orient the guide limb vertically from the posterior fourchette to the anus. While a single cut was preferred, a stagger cut was needed for some women. Postdelivery angles were measured by placing a protractor transparency on the perineum after delivery and marking the angle with an indelible ink pen. Per rectal examination was performed prior to suturing to detect OASIs. Results: A total of 25 women underwent clinically indicated episiotomies. Of these, 16 women were nulliparous, eight women were para 1, and one woman was a para 2. One woman had a vaginal breech delivery (para 2), and the rest were cephalic vertex deliveries. The average age was 27 (range 20–35) years. The median birth weight was 2,800 g (standard deviation 312 g, interquartile range 2,500–3,000 g). The median postdelivery suture angle of the episiotomy was 50° (standard deviation 3.5°, interquartile range 48°–54°, range 45°–55°). No cases of OASI were detected in this series. Conclusion: The Episcissors-60 angled version demonstrated a postdelivery suture angle of 50° in a cohort of Indian women undergoing spontaneous vaginal deliveries. Keywords: 60° episiotomy, anal incontinence, episiotomy scissors, Episcissors-60, obstetric anal sphincter injuries (OASIs), Indian womenPatel RPUbale SMDove Medical PressarticleMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol 2014, Iss default, Pp 253-256 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical technology R855-855.5
spellingShingle	Medical technology R855-855.5 Patel RP Ubale SM Evaluation of the angled Episcissors-60® episiotomy scissors in spontaneous vaginal deliveries
description	Rajnish P Patel,1,2 Sunita M Ubale21Suyog Women's Hospital, 2Rajiv Gandhi Medical College, Thane, IndiaBackground: Obstetric anal sphincter injuries (OASIs) are the leading cause of anal incontinence in women. Episiotomies with a postdelivery suture angle of less than 30° to the midline are more likely to injure the anal sphincter directly, while those with a suture angle of more than 60° are associated with increased incidence of OASIs, as they do not relieve the pressure on the perineum. A safe zone of 40°–60° has been proposed. Recently, two new types of episiotomy scissors (Episcissors-60® Straight version and angled version) were introduced to ensure a standardized cutting angle of 60° to the midline. We audited our results with the angled Episcissors-60 in spontaneous vaginal deliveries. Materials and methods: Consecutive patients delivering in two private maternity hospitals in Thane, India undergoing clinically indicated episiotomies were included. Only patients delivering spontaneously were included. The scissors were introduced vaginally at crowning, and aligned to orient the guide limb vertically from the posterior fourchette to the anus. While a single cut was preferred, a stagger cut was needed for some women. Postdelivery angles were measured by placing a protractor transparency on the perineum after delivery and marking the angle with an indelible ink pen. Per rectal examination was performed prior to suturing to detect OASIs. Results: A total of 25 women underwent clinically indicated episiotomies. Of these, 16 women were nulliparous, eight women were para 1, and one woman was a para 2. One woman had a vaginal breech delivery (para 2), and the rest were cephalic vertex deliveries. The average age was 27 (range 20–35) years. The median birth weight was 2,800 g (standard deviation 312 g, interquartile range 2,500–3,000 g). The median postdelivery suture angle of the episiotomy was 50° (standard deviation 3.5°, interquartile range 48°–54°, range 45°–55°). No cases of OASI were detected in this series. Conclusion: The Episcissors-60 angled version demonstrated a postdelivery suture angle of 50° in a cohort of Indian women undergoing spontaneous vaginal deliveries. Keywords: 60° episiotomy, anal incontinence, episiotomy scissors, Episcissors-60, obstetric anal sphincter injuries (OASIs), Indian women
format	article
author	Patel RP Ubale SM
author_facet	Patel RP Ubale SM
author_sort	Patel RP
title	Evaluation of the angled Episcissors-60® episiotomy scissors in spontaneous vaginal deliveries
title_short	Evaluation of the angled Episcissors-60® episiotomy scissors in spontaneous vaginal deliveries
title_full	Evaluation of the angled Episcissors-60® episiotomy scissors in spontaneous vaginal deliveries
title_fullStr	Evaluation of the angled Episcissors-60® episiotomy scissors in spontaneous vaginal deliveries
title_full_unstemmed	Evaluation of the angled Episcissors-60® episiotomy scissors in spontaneous vaginal deliveries
title_sort	evaluation of the angled episcissors-60® episiotomy scissors in spontaneous vaginal deliveries
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/92f611da9f0c411a8e207ec45f4f0609
work_keys_str_mv	AT patelrp evaluationoftheangledepiscissors60regepisiotomyscissorsinspontaneousvaginaldeliveries AT ubalesm evaluationoftheangledepiscissors60regepisiotomyscissorsinspontaneousvaginaldeliveries
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Evaluation of the angled Episcissors-60&reg; episiotomy scissors in spontaneous vaginal deliveries

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Evaluation of the angled Episcissors-60® episiotomy scissors in spontaneous vaginal deliveries