POST EPISIOTOMY CARE

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    I AM LOOKING FOR INFORMATION REGARDING USE OF TOPICAL AFTER EPIS. I HAVE WORKED L&D FOR 6 YEARS-AT THE HOSPITAL I USED TO WORK WE USED TUCKS AND ANNUSOL CREAM-ALONG WITH DERMOPLAST SPRAY AND LOTS OF ICE PACKS. I HAVE RECENTLY STARTED WORKING AT A MUCH SMALLER COMMUNITY HOSPITAL, AND THEY DO NO USE TOPICALS AS OFTEN. MOST OF THE DOCS HAVE TUCKS ON THEIR STANDING ORDERS FOR EPIS-BUT NOT ANY ANNUSOL, AND THE NURSES DON'T EVEN USE THE TUCKS MUCH. THIS IS A MARKED DIFFERANCE TO WHAT I WAS USED TO. I AM GOING TO BE GIVING AN INSERVICE TO STAFF SOON REGARDING POST PARTUM PAIN MANAGEMENT AND WOULD LIKE SOME FEEDBACK ON WHAT OTHER PLACES ARE DOING, ALONG WITH ANY ARTICLES ON THE SUBJECT. I WAS TAUGHT TO HAVE PTS PUT ANNUSOL CREAM ON THE TUCKS PAD, AND PLACE THAT DIRECTLY ON HEMMOHOIDS AND/OR EPIS. WHEN I TOLD THIS TO CURRENT CO-WORKERS THEY WERE SHOCKED. PLEASE SEND ME ANY INFO YOU HAVE, AND YOUR PERSONAL EXPERIENCE OR PREFERANCE. THANK YOU!!!!

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    KATE
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  4. 13 Comments so far...

  5. 0
    When I had my second child the hospital I was in gave us Dermoplast along with ice packs, if needed. For those who were in a great deal of pain they offered a sitz bath.
    Hope that was of some help
  6. 0
    Originally posted by Youman:
    When I had my second child the hospital I was in gave us Dermoplast along with ice packs, if needed. For those who were in a great deal of pain they offered a sitz bath.
    Hope that was of some help
    Have seen many ways in treating episiotomies. The way you describe and several others.Presently we use ice packs, tucks and Sitz baths x 3-4 a day. The sitz baths work the best in relieving discomfort and promoting increased circulation. Tucks are a comfort measure. This is a most satisfactory method of treatment. We deliver between 300-350 deliveries monthly. It is seldom we have an infection.
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    I dont know if this is too late or not, but i figured i could try and help. When i had my daughter i recieved tucks, dermoplast spray, a cream and a few other things. I was also told that i could do the sitz bath when i took my shower that night(i had complications) I didnt recieve an ice pack altough im sure i could have had one if i had asked....i know i wont get sympathy nor do i want it- but after almost 29 hours of labor, and delivering a 8 lb 9 oz baby, the last thing i wanted was to have anything touch me from chin down!! =)
  8. 0
    When I had my 11 lb. 2oz. son, the nurses gave me Dermoplast and some tucks pads,which were a GREAT relief along with the sitz baths!!!=)
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    Most effective for me personally was Epifoam (wonderful stuff!) on the peri pad, as well as Tucks, and the heat lamp. I found sitz baths to be less than ideal. Ice helped a lot too.
  10. 0
    This is really important, every woman on the planet should have a vairety of topicals at her disposal after an episiotomy. I was miserable, after over 24 hr's of labor (4 1/2) of pushing, which by the way was 5 years ago, not in the stone age before c-sections. After a brief nap, I woke up, epidural having worn off and got off of the bed to got to the bathroom, hubby at my side for assistance. I felt "something" between my legs, and I reached down to feel while telling my husband I felt like someone had put a brick or something between my legs, and asked him if he saw anyone putting anything down there. Unable to determine by feel exactly what was between my legs by feel, I asked my husband to look and tell me. He looked, and with a very surprised look he said, "it's you hon" well on second feel I realized that from 4 hrs of pushing I was so swollen it was no longer recognizable. The doctor, with a growing enterage of other doctors and nurses, came in to see, consult with one another and decide on how to deal with my problem. I don't know how I would have gone through the next few days without my dermoplast, my proctosol hc, my tucks, my sitz baths, witchazel compreses (to reduce swelling) and even a heat lamp that they dug up for me because I was in such bad shape, one more thing, for your lecture I thought I might add. Make sure that the tv in the patients room is tuned in to a non-comedic show, laughing really pulls those sutures!!!!!!!!!
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    Don't know if this helps but at are hospital tucks are automatically given to any woman who has devliered a infant regardless or route. We treat with ice the first 24 hours then hot sitz baths. One group of docs prefer dermaplast and the other epifoam. I myself has a fourth degree with my last child and would never had made it without my dermaplast. Anusol is used in some cases and hydrocortisone cream. Have your co-workers ever given birth!?!?!?!
  12. 0
    Everyone has missed one point here! If the perineum is prepared with pre-natal massge, compress during labor and allowed to tear the chances are there will not be a tear or repair in the first place!

    Second if during transition a homeopathic remedy known as arnica is applied the edema in the vulva is reduced and lessons the need for an episiotomy or sutures. I think the arnica would also help post-partum as well for comfort reasons! I also think if the woman labors in a birthing tub her risk for an episiotomy is also reduced! I would tske that one step further but in the USA in is not common to birth in the tub unless it is a homebirth!

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    Visit my web site at <A HREF="http://www.geocities.com/4birthing" TARGET=_blank>http://www.geocities.com/4birthing
    </A>Have a Blessed and Peaceful Day,
    Jami
    DoulaNurse@hotmail.com
  13. 0
    I worked in postpartum for 12 years. Used Dermaplast spray, Tucks, Anusol, oral pain meds. Ice packs the first 12-24 hours, then sitz baths. Of course avoiding an episiotomy altogether is always best. Perineal message can be very effective. Sounds like your organization is trying to cut costs, while jeopardizing patient care. There is no reason for these postpartum women to suffer!


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