OBSintermediate

Arrange the steps of an episiotomy repair in the correct anatomical and procedural sequence, from first to last.

Answer

Repair the vaginal mucosa, Approximate the perineal muscle layer, Close the perineal skin, Perform a digital rectal examination

Explanation

The lecture describes layered repair beginning with the vaginal layer, followed by the muscle layer and perineal skin. A rectal examination is then performed to check for injury. The repair should be done with good lighting, appropriate positioning, and local anaesthesia; any vaginal pack used to keep the field clear must be removed.\n\n**Key takeaway:** Repair from the vaginal layer outward, then perform a rectal check.\n\n**Glossary:** **Layered repair**: Closure of successive anatomical tissue layers; **perineal skin**: Skin covering the perineum.

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