• The abused perineum

      Steen, Mary; Leeds Teaching Hospitals NHS Trust (Mark Allen Publishers, 1998-07-02)
      This article discusses whether too many second degree tears are being left to heal themselves, when in fact they should be sutured. There is a need for more research based evidence by randomised controlled trial to help with decisions as to the best treatment
    • Alleviating postnatal perineal trauma: To cool or not to cool?

      Steen, Mary; Briggs, Michelle; King, David; UCLan/University of Leeds/Royal College of Midwives (Mark Allen Publishing, 2006-05-01)
      This article discusses the evidence reported from quasi randomised trials and randomised controlled trials on the efficacy and acceptability of localised cooling methods in alleviating perineal trauma. Two types of cooling methods were identified: iced sitz baths and cooling devices. The review suggests that cooling may lower the levels of reported perineal pain after childbirth and reduce the inflammatory response associated with perineal trauma. However, women's preferences as well as the efficacy of the cooling method should be taken into consideration. Women's natural reluctance to sit in iced sitz baths suggests that this cooling method is unpleasant and may explain why there has been a decline in this method being used in clinical practice over the last two decades. The use of localised cooling devices appear to be a more acceptable method for women.
    • Cold therapy and perineal wounds: Too cool or not too cool?

      Steen, Mary; Cooper, Keith; Leeds Teaching Hospitals NHS Trust/Leeds Metropolitan University (Mark Allen Publishers, 1998-09-03)
      Perineal trauma following childbirth often has numerous negative consequences for many women and the associated pain can dominate the experience of early motherhood. Applications of cold compresses have been in use for centuries as a form of localized treatment and these have become a generally accepted method to treat acute injuries. However, concerns have been expressed as to whether cold therapy can delay wound healing. The purpose of this article is to review the recent evidence concerning the beneficial use of cold therapy, when applied locally to perineal wounds and non-perineal wounds and to consider if such treatment may have an adverse effect on the rate of wound healing. In addition, the mechanism of the action of cold therapy is discussed. We conclude that there is no clear evidence to support the suggestion that when controlled therapy is applied to the traumatized perineum or other injured parts of the body that this will result in a delay in wound healing. Such treatment should continue until clear evidence is produced to the contrary.
    • Perineal tears and episiotomy: How do wounds heal?

      Steen, Mary; UCLan/Royal College of Midwives (Mark Allen Publishing, 2007-05-01)
      The care of perineal wounds is an important aspect of postnatal care. This article focuses on the healing of perineal wounds, describes tissue trauma, different types of wounds and classification of perineal wounds. Wound healing, factors that can prevent healing and the need to provide adequate pain relief that will have no adverse effect on healing are discussed in detail.