Box cutters are what obstetricians use to do episiotomies. Don't you people know nothin'?

Nope. I've seen it done. They use (shudder) scissors!

If you research it, you'll find that both scissors and scalpels have been used and I've seen it done both ways. I've even seen it done using just a blade, without a scalpel handle, choking up on it to expose the right length of blade beyond the fingertips to achieve the desired depth of incision regardless of the patient's movements.

You mean length, I think, rather than depth - it has to be full thickness or it's useless, but you don't want it any longer than necessary. (Trust me, you don't want it at all!) :eek:

I'm considering that both length and depth are important considerations:

"The present study showed that scarred episiotomies with depth > 16 mm, length > 17 mm, incision point > 9 mm lateral of midpoint and angle range 30–60° are significantly associated with less risk of OASIS. Shrinkage of tissue must be considered."

"The odds ratio estimates show that there is a 70% reduced risk (OR 0.30, 95% CI 0.14–0.66) of sustaining an anal obstetric sphincter rupture for each 5.5-mm increase in depth of the episiotomy. In addition, by increasing the distance from the posterior fourchette to the incision point of the episiotomy by 4.5 mm the risk for an obstetric anal injury decreases by 56% (OR 0.44, 95% CI 0.23–0.86). Also, there is a 75% reduced risk (OR 0.25, 95% CI 0.10–0.61) of obstetric anal injuries for each 5.5-mm increase in the length of the episiotomy, and there is an increased risk of sustaining such an injury when the angle is either <15 or >60° (OR 9.0, 95% CI 1.1–71.0)."

"This case–control study demonstrated that point of incision, length and depth as well as angle are all parameters associated with anal sphincter injury. Incisions very close to the posterior fourchette, short episiotomies, angles smaller than 15° or larger than 60° and short depth are factors that increase the risk of third-degree and fourth-degree perineal tears."

"Further, depth and episiotomy length were the most significant characteristics associated with less risk of OASIS when compared with incision point. Our findings might indicate that to unload the perineum sufficiently the episiotomy must obtain a certain length and depth."

I witnessed exactly one performed. The doc was doing her thing, and in the middle of it all, just reached over, grabbed the scissors, and snip. It was over before I realized what she was doing. I'm skeptical that it was necessary, but who knows? Maybe there would have been tearing. It made recovery more painful and take a little longer.

DO. NOT. WANT. *SHUDDERS*

Wtf is an episio--HOLYSHIT!

I know right?

Now go apologize to your mother.

^HAHAHAHAA