| Pg.
|
| How to Use This Manual................................. | 1
|
| Ethical Considerations........................................................... | 6
|
| Pertinent Anatomy................................................................. | 11
|
| Suturing and Related Equipment................................................ | 33
|
| BASIC PRINCIPLES AND TECHNIQUES................................. | 53
|
| Preventing Tears........................................................... | 54
|
| Clitorotomy/Episiotomy.................................................... | 76
|
| Basic Principles of Wound Healing and Surgical Repair....................... | 85
|
| Avoiding Contamination from Infectious Agents....................................... | 89
|
| Learning to Recognize Tissue Layers......................................... | 94
|
| Developing Your Own Style of Repair............................ | 95
|
| PRACTICING: BASIC LESSONS IN TECHNIQUE............................................ | 97
|
| Tying Knots..................................................... | 98
|
| Using Hemostatic Instruments............................................... | 108
|
| The Needle Holder........................................................ | 109
|
| Using Tissue Forceps ................................... | 112
|
| Using Surgical Scissors.......................................... | 114
|
| The Basic Stitches............................................. | 116
|
| Learning to Identify the Perineal Muscles................................ | 123
|
| ASSESSING GENITAL DAMAGE.......................... | 125
|
| Checking Prenatally for Previous Damage...................................... | 126
|
| Herniations of the Wall of the Yoni and Uterine Prolapse........................... | 127
|
| Previous Clitoridectomy and Infibulation............................ | 135
|
| Examining the Perineum After Birth: Step by Step.............................. | 140
|
| Assessing the Degree of Damage............................ | 151
|
| PREPARING TO SUTURE.......................... | 157
|
| Setting Up......................................................... | 158
|
| Local Anesthetic...... | 161
|
| Before You Begin Your Repair............................ | 169
|
| PUTTING IT ALL TOGETHER: FIRST AND SECOND DEGREE REPAIR................... | 175
|
| Repairing the Yoni Mucosa...................... | 176
|
| Muscle Repair.................................................. | 180
|
| Suturing the Perineum.................................................... | 186
|
| THIRD AND FOURTH DEGREE REPAIR............................ | 193
|
| Repairing the Anal Sphincter................................................................... | 194
|
| Repairing the Rectal Mucosa................... | 199
|
| Examining the Rectum for Misplaced Stitches...................... | 203
|
| UNUSUAL REPAIRS AND OTHER PROBLEMS........................ | 205
|
| Periurethral and Labial Repairs............................................... | 206
|
| Dealing With Skin Tags............................................................. | 210
|
| Hematomas........................................................................... | 214
|
| Cervical Lacerations.............................................................. | 216
|
| Repairing the Upper Wall of the Yoni................................................. | 220
|
| Inclusion Cysts.......................................................... | 223
|
| Dealing With a Bleeding Vessel........................................................ | 224
|
| Special Tricks and Techniques........................................ | 226
|
Repairing a pocket in the yoni mucosa; Finding an invisible apex; Removing misplaced stitches; Sulcus tears; Repairing a mediolaterial tear or cut; Tears which have small side deviations (forked tears); When one longitudinal edge of a tear protrudes more than the other; How to use tissue adhesive; The "U" (interrupted running mattress) stitch; If your suture strand is quite short and you must tie a knot
|
| POSTPARTUM CARE.......................................................................... | 233
|
| General Care and Comfort Measures............................. | 234
|
| Checking Tears and Repairs in the Weeks Postpartum....... | 243
|
| Allergic Reactions................................................................ | 248
|
| Perineal Infections..................................................................... | 294
|
| If a Repair Breaks Down........................................................................... | 255
|
| APPENDIX ................................................................................. | 259
|
| Record Keeping........................................................................... | 260
|
| What is Homeopathy?........................................................................... | 261
|
| Herbal Medicine........................................................................... | 266
|
| Using Your Video Tape as a Teaching Tool................................................ | 271
|
| 3-Dimensional Models of the Pelvic Muscles................................. | 278
|
| Sources of Suture and Other Materials................................. | 291
|
| BIBLIOGRAPHY................................................................................. | 293
|
