61
Operative Obstetrics
Pearls
Chapter 6
Richard A. Latta, MD
❍ What type of needle tip should be used to close the fascia of a Pfannenstiel skin incision?
Taper needles. Cutting needles or reverse cutting needles increase the risk of pull through. Blunt needles are used
for friable tissues.
❍ What tissues are disrupted in a first-degree laceration?
This is defined as superficial laceration of the vaginal mucosa or perinatal body not requiring suturing.
❍ What tissues are involved in a second-degree laceration or episiotomy?
This involves the vaginal mucosa and perineal skin and deeper subcutaneous tissue and requires suturing.
❍ Define a fourth-degree laceration.
This involves extension of an episiotomy or laceration into the rectal mucosa.
❍ True or False: Episiotomy increases the risk of disruption of the rectal sphincter.
True.
❍ Myonecrosis of the deep fascia is most often associated with infection by which organism?
Clostridium perfringens.