open access

Vol 89, No 10 (2018)
Research paper
Published online: 2018-10-31
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New porcine model of perineal tear and its utility in physicians’ training on the reconstruction of 3rd and 4th degree perineal tear during vaginal delivery

Przemysław Ciesielski12, Małgorzata Kołodziejczak1, Paweł Dutkiewicz2
DOI: 10.5603/GP.a2018.0095
·
Pubmed: 30393844
·
Ginekol Pol 2018;89(10):558-562.
Affiliations
  1. Warsaw Proctology Centre, Saint Elisabeth Hospital, Warsaw, Poland, Poland
  2. Department of General Surgery, District Hospital in Wołomin, Poland, Gdynska 1/3, 05-200 Wolomin, Poland

open access

Vol 89, No 10 (2018)
ORIGINAL PAPERS Gynecology
Published online: 2018-10-31

Abstract

Objectives: One of the most serious complications of vaginal delivery is 3rd and 4th degree perineal tear and its incorrect management results in anal incontinence. Animal-based anatomical models of childbirth-induced perineal tear are an important element of the physicians’ practical training [1]. The proposed new model, prepared using porcine tongue and intestine, closely mimics all the tissues and organs subjected to injury during complicated deliveries and constitutes an educational opportunity for the reconstruction of the injuries.
The objective of this paper was to present a new porcine model of the perineum and to evaluate the utility of this model in the training of physicians on the reconstruction of the 3rd and 4th degree perineal tear during childbirth.
Material and methods: We presented a preparation method of the proposed model and a calculation of the amount of time and costs required for its preparation. The utility of the model was assessed using a questionnaire completed by the participants of a workshop conducted with the model.
Results: We found that 95% of the respondents had never practiced perineal reconstruction on any model. According to 85% of the respondents, our model was very similar to natural tissues. According to 95% of the respondents, the simulated model of the perineal tear satisfactorily mimicked the real-life situation.
Conclusions: The presented model is cheap and easy to prepare. It satisfactorily mimics the tissues and tissue injuries caused by the tear, making it helpful in training physicians on the reconstruction of 3rd and 4th degree perineal tear.

Abstract

Objectives: One of the most serious complications of vaginal delivery is 3rd and 4th degree perineal tear and its incorrect management results in anal incontinence. Animal-based anatomical models of childbirth-induced perineal tear are an important element of the physicians’ practical training [1]. The proposed new model, prepared using porcine tongue and intestine, closely mimics all the tissues and organs subjected to injury during complicated deliveries and constitutes an educational opportunity for the reconstruction of the injuries.
The objective of this paper was to present a new porcine model of the perineum and to evaluate the utility of this model in the training of physicians on the reconstruction of the 3rd and 4th degree perineal tear during childbirth.
Material and methods: We presented a preparation method of the proposed model and a calculation of the amount of time and costs required for its preparation. The utility of the model was assessed using a questionnaire completed by the participants of a workshop conducted with the model.
Results: We found that 95% of the respondents had never practiced perineal reconstruction on any model. According to 85% of the respondents, our model was very similar to natural tissues. According to 95% of the respondents, the simulated model of the perineal tear satisfactorily mimicked the real-life situation.
Conclusions: The presented model is cheap and easy to prepare. It satisfactorily mimics the tissues and tissue injuries caused by the tear, making it helpful in training physicians on the reconstruction of 3rd and 4th degree perineal tear.

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Keywords

perineal tear; sphincter reconstruction; animal model of perineal tear

About this article
Title

New porcine model of perineal tear and its utility in physicians’ training on the reconstruction of 3rd and 4th degree perineal tear during vaginal delivery

Journal

Ginekologia Polska

Issue

Vol 89, No 10 (2018)

Article type

Research paper

Pages

558-562

Published online

2018-10-31

DOI

10.5603/GP.a2018.0095

Pubmed

30393844

Bibliographic record

Ginekol Pol 2018;89(10):558-562.

Keywords

perineal tear
sphincter reconstruction
animal model of perineal tear

Authors

Przemysław Ciesielski
Małgorzata Kołodziejczak
Paweł Dutkiewicz

References (9)
  1. Illston JD, Ballard AC, Ellington DR, et al. Modified Beef Tongue Model for Fourth-Degree Laceration Repair Simulation. Obstet Gynecol. 2017; 129(3): 491–496.
  2. Smith LA, Price N, Simonite V, et al. Incidence of and risk factors for perineal trauma: a prospective observational study. BMC Pregnancy Childbirth. 2013; 13: 59.
  3. Dudding TC, Vaizey CJ, Kamm MA. Obstetric anal sphincter injury: incidence, risk factors, and management. Ann Surg. 2008; 247(2): 224–237.
  4. Harvey MA, Pierce M, Alter JEW, et al. Society of Obstetricians and Gynaecologists of Canada. Obstetrical Anal Sphincter Injuries (OASIS): Prevention, Recognition, and Repair. J Obstet Gynaecol Can. 2015; 37(12): 1131–1148.
  5. Kołodziejczak M. Poporodowa niewydolność mięśni zwieraczy. In: Leczenie chorób proktologicznych w okresie ciąży i porodu. 1st ed. Warsaw: Borgis. ; 2011: 135–138.
  6. Reid AJ, Beggs AD, Sultan AH, et al. Outcome of repair of obstetric anal sphincter injuries after three years. Int J Gynaecol Obstet. 2014; 127(1): 47–50.
  7. Patel M, LaSala C, Tulikangas P, et al. Use of a beef tongue model and instructional video for teaching residents fourth-degree laceration repair. Int Urogynecol J. 2010; 21(3): 353–358.
  8. Dancz CE, Sun V, Moon HB, et al. Comparison of 2 simulation models for teaching obstetric anal sphincter repair. Simul Healthc. 2014; 9(5): 325–330.
  9. Siddighi S, Kleeman SD, Baggish MS, et al. Effects of an educational workshop on performance of fourth-degree perineal laceration repair. Obstet Gynecol. 2007; 109(2 Pt 1): 289–294.

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