perineal care is much important after delivery of the baby or during postnatal period

1. PERINEAL CARE
Definition:
It is an aseptic irrigation or sponging of the perineum during a specific
period following delivery or operation on the reproductive system, urinary
meatus or anus. It is defined as the care provided to clean the external genitalia
and the surrounding area in-order to maintain the perineum hygiene.
Purposes:
1. To clean the perineum.
2. To relieve inflammation.
3. To relieve pain.
4. To stimulate circulation.
5. To prevent the spread of infection and bacterial growth.
6. To promote healing.
7. To apply medication over episiotomy wound and any other perineal wound.
8. To promote a sense of well-being and comfort.
Indications
 Mothers who are unable to do self-care.
 Mothers with genitourinary tract infection.
 Postnatal mothers.
 Mothers with excessive vaginal discharge.
 Before procedure like per vaginal examination and catheterization.
 Mothers after surgery on the genitourinary system.
 Gynaecological conditions like vaginitis, prolapse of uterus, etc.
Steps of the Procedure Before Procedure
Preparationof the mother
 Explain the procedure to the mother and make her comfortable on the
bed/examination table.
 Provide privacy by screen.
 Drape the mother as per for vaginal examination — fanfold the top linen.
 Spread out the mackintosh.
 Offer the bed pan to the mother — place the bed pan in position and
adjust it comfortable for the mother.

2.  Ensure that there is adequate light and put off the fan.
Preparationof the article
Articles required
Articles Rationale
A Sterile Tray Containing
 A bowl with sterile 9—11
cottonswabs soaked in Savlon
solution of 1:20 ratio.
 A bowl with sterile 9—11
cottonswabs soaked normal
saline or boiled and coolcotton
swabs.
 Artery forceps, spongeholding
forceps – 1.
 Dissecting forceps — 1.
 Bowl with sterile gauze pieces
(9-11).
 1 pair of gloves.
 1-2 sanitary pads.
 Betadine ointment
 To clean the perineum
 To clean the perineum
 To hold the swabs for cleaning
 To pick the cottonswab from
the bowl
 To dry tie perineum
 To maintain sterility and
selfprotection
 For perineal discharge soakage.
 To apply over the episiotomy
wound.
A Clean Tray Containing
 A bow with warm water or
normal saline.
 Mackintosh (medium) — 1.
 Bed sheet — 1.
 BP apparatus with stethoscope
 Measuring tape.
 3 or 4 cotton pads
 Kidney tray medium – 1
 Paper bag (big)- 1
 Piece of paper
 T binder
 Scissors
 Screen
 Bed pan
 To flush the perineum
 To prevent the soiling of the bed
 To drape the mother
 To check the blood pressure
 To check the fundal height
 For examination of the breast
and to clean the buttocks
 To squeeze the cottonswabs
 To receive the waste
 To remove the soiled pad
 To tie the pad
 To cut the extra binder
 To provide privacy
 To collect the flushed water

3. Actual Steps of the Procedure:
 Collect all the articles.
 Wash hands.
 Be on the right side of the mother.
 Perform complete postnatal examination.
o Head-to-foot examination
o Breast examination
o Abdominal examination: Locate the fundus, give gentle fundal
massage and check fundal height
 Loosen the soiled pad: Take it out holding it with the paper and then
observe the type. colour, amount and odourof lochia.
 Wrap the soiled pad with the paper and discard it in the dustbin.
 Spread the mackintosh to protectthe soiling of bed.
 Put the bed pan and make the mother comfortable on it.
 Pour lukewarm water over the perineum.
 Wash hands.
 Wear gloves. Clean the perineum using wet Savlon swabs with forceps
from above downwards in the following order in a single stroke manner.
o The vulva
o Labia minora — farthest side
o Labia minora — nearest side
o Inner side of the labia majora — farthest side
o Inner side of the labia majora — nearest side
o Outer side of the labia majora — farthest side
o Outer side of the labia majora — nearest side
 Clean the episiotomy wound in one stroke.
 Clean the anus thoroughly in a circular motion.
 Clean the perineum with normal saline swab in the same order.
 Dry the perineum in the same order.
 Apply the Soframycin ointment or Betadine ointment/solution over the
wound.
 Apply the pad over the perineum.
 Remove the bed pan.
 Secure the pad with 'T' binder.
 Turn the mother to her left side and clean the buttocks in upward
direction. Aftercare of the Mother and Articles
 Make the mother comfortable

4.  Remove the bed pan and mackintosh and replace all the articles after
washing for sterilizing.
 Inform the mother about the nature of lochia and condition of the perineal
wound.
 Tidy the unit.
Recording and Reporting
Record and report the observation made in the nurse's notes and mother's
clinical Chan