What is reeda

An ordinary bathtub can be filled with 3 to 4inches 7. A quasi-experimental study conducted to assess the effectiveness of sitz bath in reduction of episiotomy pain and wound healing among postnatal mothers admitted in postnatal units of DMC Hospital and Deep Hospital, Model town, Ludhiana, Punjab.

The sample was 60 postnatal mothers with episiotomy 30 in each experimental group and 30 in control group. Experimental group received sitz bath and control group received routine care. For the present study, Quantitative research approach and quasi-experimental design Non—equivalent, post-test only design was used. The research setting was Govt. The sample consisted of 40 postnatal mothers 20 in experimental 20 in control group with episiotomy.

Prior to the data collection procedure, formal permission was obtained from the Medical Superintendent of hospital. Socio-demographic profile, Obstetrical history variables tool and REEDA scale was used to collect personal information. Socio-demographic profile included items like age in years , educational status, occupational status, family income, residence, religion and dietary pattern. Obstetrical History Variables included type of episiotomy, Parity, Antibiotics prescribed and Analgesics prescribed.

Each area is given a minimum score of 0 and maximum score of 3. The total score is It is scored as No infection 0 , mild infection , moderate infection and severe infection Measurement of wound was done by paper centimetre scale.

Data collection was done in January Prior to interview the questionnaire to the postnatal mothers, investigator gave self introduction to the subjects and explained the purpose of gathering information. A good rapport was established with the subjects. They were assured that their responses will be used kept confidential and the information will be used only for research purpose.

Formal consent was taken from subjects. The time taken by each respondent for filling the tool was average for minutes. Table 3A Reveals the effectiveness of medicated sitz bath on episiotomy wound healing among postnatal mothers in experimental group. It shows that highest mean score 6. Hence the difference in episiotomy wound healing among postnatal mothers were highly significant in experimental group. Table 4A reveals the effectiveness of non-medicated sitz bath on episiotomy wound healing among postnatal mothers in control group.

It shows that highest mean score 8. Hence, the differences in episiotomy wound healing among postnatal mothers were highly significant in control group.

Table 5 reveals the comparison the post test level of episiotomy wound healing among postnatal mothers between experimental and control group. The highest mean score 6. The significant difference among post test shows that there is no significant difference was observed in experimental and control group.

Both are equally effective. Table 1 Frequency and percentage distribution of demographic variables of postnatal mothers. Table 2 Frequency and percentage distribution of obstetrical history variables of postnatal mothers. Table 3A Effectiveness of medicated sitz bath on episiotomy wound healing among postnatal mothers in experimental group.

Table 3B Frequency and percentage distribution of effectiveness of medicated sitz bath on episiotomy wound healing among postnatal mothers in experimental group.

Table 4A Effectiveness of non-medicated sitz bath on episiotomy wound healing among postnatal mothers in control group. Table 4B Frequency and percentage distribution of effectiveness of non- medicated sitz bath on episiotomy wound healing among postnatal mothers in control group.

Table 5 Comparison the post test level of episiotomy wound healing among postnatal mothers between experimental and control group. Objective 1: To assess the effectiveness of medicated sitz bath on episiotomy wound healing among postnatal mothers in experimental group.

The study results shows that highest mean score 6. Hence the differences in episiotomy wound healing among postnatal mothers were highly significant in experimental group. It shows the effectiveness of medicated sitz bath on episiotomy wound healing among postnatal mothers in experimental group. A similar study conducted to assess the effects of olive oil sitz bath on improvement of perineal injury after delivery. Any case of ecchymosis, discharge and approximation distance between the wound edges was not observed in the olive group but those signs were observed in the control group.

An episiotomy is usually repaired within an hour after delivery. The incision may bleed quite a bit at first, but should stop once your doctor closes the wound with sutures. After having an episiotomy , it's normal to feel pain around the incision site for two to three weeks.

The anatomic structures involved in a mediolateral episiotomy include the vaginal epithelium, transverse perineal muscle, bulbocavernosus muscle , and perineal skin. An episiotomy is a surgical incision, usually made with sterile scissors, in the perineum as the baby's head is being delivered.

In other cases, the episiotomy is performed by making a diagonal incision across the midline between the vagina and anus called a mediolateral incision. The procedure. If you have an episiotomy , your doctor will give you a shot of local anesthetic to numb the area before cutting, unless the area is already numb from your epidural. After your baby is born, your doctor will stitch the episiotomy and other tears with dissolvable sutures.

The episiotomy tradition For years, an episiotomy was thought to help prevent more extensive vaginal tears during childbirth — and heal better than a natural tear. Today, however, research suggests that routine episiotomies don't prevent these problems after all. An episiotomy is a surgical cut made through the muscular area between the vagina and the anus also called perineum.

It is made by a doctor or midwife in order to make the opening wider, and possibly to prevent a more serious tear. Episiotomies have the following potential side effects: Infection. Extended healing time. Painful scarring that might require a period of abstinence from sexual intercourse. Future problems with incontinence. Local anesthesia is injected into a specific area to provide pain relief during labor.

It is also given near the end of birth for an episiotomy , to relieve the discomfort of the perineum stretching and also after birth to repair tears and episiotomies.

Other studies also highlight the difficulty of identifying and assessing perineal oedema and ecchymosis in clinical practice with the use of other measurement instruments. In a study 20 carried out to develop and validate an instrument to assess the severity of perineal trauma based on the degrees of oedema and ecchymosis, twenty women, evaluated up to 48 h after episiotomy, were divided into two groups and assessed by two experienced and two newly trained midwives.

The instrument consisted of pictures that represented different degrees of oedema and ecchymosis, classified using the categories none, mild, moderate and severe, followed by the application of a categorical scale. The Kappa coefficient displayed excellent reliability among the examiners 0. However, in 9 cases there was difficulty in the oedema classification, and there was difficulty in 4 cases of ecchymosis. The less experienced professionals displayed more uncertainty in the application of the scale The data of our study indicate that the REEDA scale scores also had better agreement among the evaluators when used at the follow-up visit, when the items with less agreement hyperaemia, oedema and ecchymosis were no longer present.

These local inflammatory signs are expected in an early phase of the healing process and decrease with the evolution of local reactions and absorption of the suture material. After nearly two weeks, the cell matrix formation and tissue remodelling is generally complete, even though this process can take several months These results indicate the need for further research to redefine the criteria for evaluating those items.

Limitations of this study included a small sample size, which was not calculated to detect a difference when comparing the evaluation of the judges. Notwithstanding, sample was enough to identify the items for which there was a low inter-rater agreement. The assessments were carried out by several professionals, which increase the variability of the data but it also allows to verify the use of the REEDA scale in a clinical setting. Of the five items of the REEDA scale, the hyperaemia, secretion and coaptation of the edge wound items displayed more consistent ratings.

The evaluation of the oedema and ecchymosis items, however, were unreliable. The scale offers a better evaluation of perineal healing when applied from 7 to 10 days after the delivery, when the items of lower correlation are no longer present.

Though the scale has a very detailed classification of the items, the evaluation criteria are not clear, which impairs its application. The difference in scores between evaluators in the scale application indicates that this instrument is not accurate and should be enhanced to facilitate data recording and the systematic evaluation of the episiotomy healing process.

A reliable instrument for assessing perineal healing is valuable to nurse-midwives, midwives and other caregivers, as a concise evaluation tool may help facilitate measures to improve perineal care. National Center for Biotechnology Information , U.

Rev Lat Am Enfermagem. Author information Article notes Copyright and License information Disclaimer. Escola de Enfermagem Av. Received Dec 13; Accepted Sep Copyright notice. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC. METHOD: observational study based on data from a clinical trial conducted with 54 randomly selected women, who had their perineal healing assessed at four time points, from 6 hours to 10 days after delivery, by nurses trained in the use of this scale. Introduction Episiotomy, a common procedure in obstetric care, is associated with the need for suture and healing complications in the postpartum period, such as blood loss, oedema, haematoma, infection wound dehiscence and perineal pain 1.

Method This is an observational study based on data obtained from a randomised, triple-blind, controlled trial on the effectiveness of Low-level Laser Therapy LLLT for the healing of episiotomies. Open in a separate window. Figure 1 -. Redness, oedema, ecchymosis, discharge and approximation of the edges of the lesion assessment scale REEDA 7.

Results This study compared evaluations of perineal healing after episiotomy among 54 postpartum women; healthcare providers used the REEDA scale to obtain these evaluations. Table 1 - Agreement on total score of the REEDA scale at the four assessments between the main researcher and evaluator. Table 2 - Comparison of the means and standard deviation SD of the REEDA scale items between the main researcher and the evaluator at the first h and second h evaluation.

Table 3 - Comparison of the means and standard deviation SD of the REEDA scale items between the main researcher and the evaluator at the third h and fourth days evaluations. Discussion Adopting protocols with well-defined criteria is essential for systematically assessing and treating injury.

Conclusions Of the five items of the REEDA scale, the hyperaemia, secretion and coaptation of the edge wound items displayed more consistent ratings. References 1. A prospective randomized comparative study of vicryl rapide versus chromic catgut for episiotomy repair. J Clin Diagn Res. Randomized controlled clinical trial on two perineal trauma suture techniques in normal delivery.

Kettle C, Tohill S. Perineal care. Clin Evid; Perineal pain following childbirth: prevalence, effects on postnatal recovery and analgesia usage. Prevalence, pathophysiology and current management of dehisced perineal wounds following childbirth. Br J Midwifery.

Hill PD. J Nurse Midwifery. Davidson N. REEDA: evaluating postpartum healing. Carey ILP. Healing of the perineum, a follow up study [thesis of the Internet] Utah: University of Utah; Postpartum perineal repair performed by midwives: a randomised trial comparing two suture techniques leaving the skin unsutured.

Ear acupuncture or local anaesthetics as pain relief during postpartum surgical repair: a randomised controlled trial. Episiotomy pain relief: use of Lavender oil essence in primiparous Iranian women.

Complement Ther Clin Pract. Effect of self perineal care instructions on episiotomy pain and wound healing of postpartum women. J Am Sci.