Elinor Jenkins
Isle of Wight NHS Trust, UK
Title: Labial trauma post birth: A Delphi study of classification and suturing requirements
Biography
Biography: Elinor Jenkins
Abstract
Introduction & Aim: Upto 49% of women sustain labial trauma during vaginal birth. Labial trauma is currently treated by midwives and obstetricians. However, there are no universally recognised descriptions of labial trauma and minimal research evidence for suturing. This study was conducted to provide guidance for current practice.
Methods: Delphi methodology was used to establish consensus for the classification and suturing requirements of several types of labial trauma. Twenty two participants with expertise in labial/perineal trauma took part. Each round consisted of six medical drawings of types and combinations of labial trauma. Each drawing had seven questions asking the participant to describe the trauma, their suturing recommendations, rationale for suturing, method of suturing, suture material, anaesthetic and technique for administration and any other comment. Numbers of agreeing participants were shown to participants on each round.
Results: Findings showed consensus that vertical skin separation of the interior aspect of the labia minora with minimal trauma to underlying tissues was described as a graze and will heal spontaneously. Deeper vertical trauma with involvement of the underlying tissue was described as a tear requiring suturing to promote healing. Lateral trauma across the labia minora was also described as a tear and needs suturing for anatomical realignment and cosmetic appearance. Suturing method should be interrupted using Vicryl Rapide 3.0 or equivalent with injected local anaesthetic.
Conclusion: This study provides unique research evidence to inform an area of practice with a limited evidence base. It also indicates future research. Its strengths are the primary data from clinical experts but its transferability now needs to be established in further research.