PERINEOTOMY CARE AFTER CHILDBIRTH

Every woman who became pregnant has to undergo the process of delivery. In normal process of delivery the baby is delivered per vagina, an episiotomy is performed by health care provider or midwife. Episiotomy is a surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labour to enlarge the vaginal introits so as to facilitate easy and safe delivery of the fetus. Episiotomy may be advice in the situations such as inelastic perineum, fetal distress, and complicated birth, prolonged second stage of labor, instrumental vaginal delivery and previous perineal surgeries .There are four types of episiotomy: midline, mediolateral, lateral and J shaped. Care of episiotomy involves perineal care, sitz bath, infrared heat, perineal exercises, antiseptic ointments, cold and hot packs The REEDA scale is used for assessing the perineal healing. Complications of episiotomy include perineal discomfort, perineal pain, difficulty with breast feeding and walking, perineal bleeding, infection, wound dehiscence and dyspareunia

Effect of sitz bath with 1.6%brine solution and metronidazole on perianal infections in acute leukemia patients / 现代临床护理

Objective To study the effect of sitz bath with 1.6%concentrated brine solution and metronidazole on perianal infection in acute leukemia patients. Methods Seventy-six acute leukemia patients admitted from June 2010 to December 2014 with perianal infections were randomly divided into the control group and the observation group in equal number. The two groups were given routine nursing care and symptomatic supportive treatment . Apart from the basic nursing , the control group was treated with sitz bath with 10 min 1 ∶ 5000 potassium permanganate. The observation group was treated with sitz bath with 1.6% brine solution and 0.1%metronidazole two times every day and another one if defecation was done. The perianal infections of two groups were compared in 7 days. Result The total effectiveness in the observation group was significantly better than that of the control group (P < 0.05). Conclusions Sits bath with 1.6% brine solution and metronidazole two times a day is more effective than with 1 ∶ 5000 potassium permanganate. It is economic and convenient, safe and effective for the treatment of perianal infections and therefore worth popularizing in clinical application.

The influence of heat-clearing and blood-activating traditional Chinese medicine sitz bath on postoperative wound healing of hemorrhoids / 中国基层医药

Objective To observe the influence of heat-clearing and blood-activating traditional Chinese medicine sitz bath on postoperative wound healing of hemorrhoids Methods 100 cases of hemorrhoids surgery pa-tients were selected.According to random number table method,they were divided into the observation group and con-trol group,100 cases in each group.All of patients underwent hemorrhoids excision surgery,the control group was giv-en potassium permanganate sitz bath, the observation group was given heat-clearing and blood-activating traditional Chinese medicine sitz bath.The two groups were given compound carraghenates cream for external use after sitz bath. The postoperative wound healing time,degree of pain and clinical efficient of the two groups were observed and com-pared.Results In two groups before treatment,the pain scores were (4.06 ±1.34)point,(4.05 ±1.36)point,with no significantly different (t=0.63,P<0.05); compared with before treatment,the two groups after treatment the pain scores were (1.13 ±0.51)point,(2.72 ±0.74)point,the difference was statistically significant (t =3.72, 2.98,P<0.05);the pain scores after treatment in observation group was significantly lower than that of the control group,the difference was statistically significant (t=2.73,P<0.05).In observation group,the wound healing time was (13.23 ±4.27)d,which was shorter than (18.78 ±6.43)d of the control group,the difference was statistically significant (t=6.44,P<0.05).The clinical efficiency of the observation group was 98%,which was significantly higher than 86%of the control group,the difference was statistically significant (χ2 =4.89,P<0.05).Conclusion Heat-clearing and blood-activating traditional Chinese medicine sitz bath can promote the healing of postoperative wound of hemorrhoids,and can effectively reduce the degree of pain.

Analgesia efficacy observation of methylene blue compound preparation combined with traditional Chinese medicine fumigation sitz bath on patients with postoperation pain after anorectal operation / 国际中医中药杂志

Objective To explore the efficacy of Methylene blue compound preparation combined with traditional Chinese medicine fumigation sitz bath on patients with postoperation pain after anorectal operation.Methods 168 cases with postoperation pain after anorectal operation were randomly divided into an observation group and a control group (both n=84).All patients were treated by Cefpiramide and Tinidazole after operation.On this basis,the patients in the observation group were treated additionally by Methylene blue compound preparation combined with traditional Chinese medicine fumigation sitz bath.Results The postoperation pain rate of the observation group was lower than that of the control group (x2 =44.21,P＜ 0.01),and the NRS score of pain in the observation group was lower than that in the control group (t=12.2,P＜0.05).There was significant difference between two groups in the urinary retention rate (x2=12.92,P＜0.01).The disappeared time of pain,the healing time of the wound in the observation group were (5.9± 2.1)d and (19.2 ± 4.8)d,both lower than those in the control group (t=6.25,5.22,P＜0.05).Conclusion Methylene blue compound preparation combined with traditional Chinese medicine fumigation sitz bath on patients with postoperation pain after anorectal operation would relieve the pain.

The efficacy of the cicatrisation-fumigant Chinese herbal on the postoperative complications of the mixed hemorrhoids / 中国综合临床

Objective To observe the efficacy of Chinese herbal fumigant sitz bath for different exposure durations on patients for the complicatiors after mixed hemorrhoidectomy.Methods One hundred and twenty patients with mixed hemorrhoidectomy were randomized into four groups(2 treatment groups and 2 control groups) with 30 cases in each group.The treatment groups were treated with the Chinese Herbal fumigant sitz bath for 10 minutes and 15 minutes respectively;while the control groups were treated with the hemorrhoids lotion for 10 minutes and 15 minutes respectively.The severity of pain,edema,bleeding,constipation and urinary disturbance were scored on the second,seventh and fourteenth days after treatment.Data were analyzed statistically.Results Chinese herbal fumigant Sitz baths for 10 minutes could significantly reduce postoperative pain,edema and bleeding symptoms[(1.72±1.23) points,(0.72±1.25) points,(0.91±1.37) points,respectively,P ＜0.05],followed sequentially by groups of Chinese herbal fumigant Sitz baths for 15 minutes [(1.79±1.21)points,(0.89±1.28) points,(1.03±1.24) points]; The hemorrhoids lotion for 10 minutes ((1.86±1.25) points,(1.14±1.47) points,(1.49±1.56)) and 15 minutes[(2.03±1.48) points,(1.05±1.29) points,(1.39±1.47) points,respectively,P ＜ 0.05]With the successful cases of 27,21,18,and 6 in the groups,respectively.Though the overall response rates of for the groups of 10 min's treatment,15min's treatment and 10 min's control were not significantly different between each other(P =0.0634,P =0.2560),they showed a superior efficacy in the overall response rate to the 15 min's control group(P =0.0064,P =0.0365,P =0.0089),respectively.Conclusion Chinese herbal fumigant Sitz baths for 10minutes have a success rate of 100％ on alleviating complications after mixed hemorrhoidectomy.It has a prominent efficacy on reducing postoperative edema and bleeding symptoms than other treatments studied in this program.

Detection of HBV DNA and HCV RNA in Public Bath; A Study about Safety of Prolapsed Hemorrhoidal Patients

PURPOSE: The Sitz bath is a commonly used nonsurgical treatment for patients with hemorrhoids. When these patients use public baths, possibilities exposure to infectious diseases due to public-bath utilization by exist for person infected with many kinds of diseases. In particular, because Hepatitis type B and type C viruses are infection sources for chronic liver diseases, we shall examine the risks of infections of HBV and HCV in acute hemorrhoids patients by examining the existences of HBV DNA and HCV RNA in the waters of public baths. RESULTS: From March 2005 to March 2006, 29 hot-water samples and 22 cold-water samples were obtained from public baths within Busan. With each sample, COBAS Amplicor HBV DNA monitor and HCV RNA monitor were used to run a quantitative (PCR) for HBV DNA and HCV RNA. Additionally, HBsAg and HBeAg were examined through chemiluminescent microparticle immuno assay (CMIA). RESULTS: HBV DNA was detected in 4 samples and HCV RNA was detected in an other 4 samples of the 29 samples from the hot baths. In 22 samples from the cold baths, HBV DNA was detected in 3 samples and HCV RNA in an other 2 samples. The mean levels of HBV DNA detected were 162.8 IU/ml and 1,586 IU/ml and the mean levels of HCV RNA were 276 IU/ml and 3,067 IU/ml from specimens in hot and cold baths, respectively. In the tests for HBs Ag and HBeAg, among 51 samples, 2 hot-water samples showed positive for HBs Ag while the others showed negative. CONCLUSIONS: HBV DNA and HCV RNA were detected in both the hot and the cold waters of public baths. However, this result cannot be regarded as demonstrating infectivity, but further studies are thought to be needed to examine the risks of infections to patients with acute hemorrhoids of higher than third degree or patients with open wounds or external orifices. A patient with hemorrhoids or fistulas with external orifices should not use public baths and should undergo curative surgery.

Clinical trial of Aromatherapy on Postpartum Mother's Perineal Healing / 간호학회지

PURPOSE: This study was designed to verify the effect of aromatherapy on a postpartum mother's perineal healing. METHOD: The research design was a clinical trial. The methods of aromatherapy were applied sitz bath or soap application using essential oils with Lavender, Myrrh, Neroli, Rose, Grapefruit, Mandarin, Orange, and Roman Chamomile. The subjects of this experiment were postpartum mothers who delivered vaginally with an episiotomy. They were allocated to one of three groups; the aroma-sitz bath group, aroma-soap application group or control group. To evaluate the effect of aromatherapy, the perineal healing status was measured using the REEDA scale and smears of episiotomy wound were obtained. The data were analyzed by repeated measures of ANOVA, ANCOVA, x2-test, and multiple response analysis via SPSS program. RESULT: The REEDA scale was significantly low in the experimental group at postpartum 5th and 7th days (P=.009, P=.003), respectively. Most were observed 'few'(5-10 bacteria per field) bacteria in the smears of episiotomy wound. The one bacteria was identified in the 50.8% of subjects in pretest and two bacteria in the 60.3% in posttest. Most frequently identified bacteria were Escherichia coli and Enterococcus faecalis. CONCLUSION: In conclusion, these findings indicate that postpartum aromatherapy for perineal care could be effective in healing the perineum perineal care could be effective in healing the perineum.

The study of warm versus, cold alternate with warm sitz bath in patients undergoing anorectal surgery.

The comparative study of warm versus, cold alternate with warm sitz baths made of 70 patients who had undergone anorectal surgery in Department of Surgery, Siriraj Hospital. The age range was 15-90 years. 55.7% of cases were in the 20-40 year range. Surgical indications were hemorrhoid, perianal abscess, and fistula in ano 28.6%, 18.6%, 47.1% respectively. Post operative, the patients were placed into 2 groups. The first, 37 cases had warm sit baths with warm temperature 98-105o F (37-40o C) and the second, 33 cases had cold water temperature 60-65o F (15-18o C) alternating with warm sitz baths. All patients had 4 sitz bath times, at 4 hours intervals and duration 15 minutes. Pain, congestion and inflammation of surgical wound was assessed by observation. Chi-square-test was used for statistically significant difference. No significant difference was observed between the 2 groups in pain, congestion and inflammation of the wound. However the group treated by cold alternating with warm sitz baths appreciated more comfortable and satisfied with their treatment than the group having warm sitz baths only.