Match each layer or step in the repair of a second-degree perineal tear to its recommended surgical technique: 1. Vaginal mucosa 2. Perineal muscles 3. Perineal skin 4. Post-repair evaluation A. Begin suturing approximately 1 cm above the apex and close with a continuous suture B. Reapproximate with interrupted or continuous absorbable sutures C. Close preferably using a subcuticular suture technique D. Perform a digital rectal examination to ensure the rectal mucosa was not breached

The supplied repair sequence describes beginning the vaginal layer about 1 cm above the apex with a continuous suture, repairing the muscle with interrupted or continuous sutures, and preferably closing the perineal skin subcuticularly. A rectal examination is performed afterward. Adequate light, lithotomy positioning, lignocaine infiltration, and removal of any vaginal pack are also noted.\n\n**Key takeaway:** Repair proceeds in layers and includes a rectal examination afterward.\n\n**Glossary:** **Apex**: The upper end of the incision; **subcuticular**: Placed just beneath the skin surface; **rectal examination**: Examination through the anus to assess for injury.