There has been an increase in litigation due to a failure of recognition of anal sphincter tears and inappropriate management. This aims to clarify and graphically demonstrate perineal anatomy and explain the pathophysiology of anal incontinence as well as applied pharmacology. It also institutes the new recommended classification of perineal tears and describes the various anal sphincter repair techniques. The emphasis is placed on the correct post-operative management, management of a subsequent pregnancy following previous anal sphincter injury and prevention of anal sphincter tears as an important issue that has not been given due consideration previously. The authors also focus on medical/legal implications in order to introduce safe medical practice. The book will mostly be of interest to trainees and consultants, colorectal surgeons, physiotherapists, midwives, continence advisors, labour wards and lawyers.In the presence of a fourth degree tear, the torn anal epithelium is repaired with interrupted Vicryl 3/0 sutures with the knots tied in the anal lumen. This technique ... The sphincter muscles are repaired with 3/0 PDS dyed sutures (Figure 4.3).
|Title||:||Perineal and Anal Sphincter Trauma|
|Author||:||Abdul H Sultan, Ranee Thakar, Dee E. Fenner|
|Publisher||:||Springer Science & Business Media - 2007-03-20|