The usefulness of gavage syringe covered by Sur-gicel for homeostasis in complicated obstetric va-ginal lacerations

Abstract

• Surgicel (oxidized regenerated absorbable cellulose) is used topically for homeostasis in surgery. Complicated obstetric vaginal laceration after vaginal delivery can be difficult to manage using traditional techniques.
  In February 2012, a 32-year-old primipara referred to our center (Shahid Beheshti Hospital, Isfahan, Iran) 10 days after vaginal delivery with moderate to severe vaginal bleeding. She had a large laceration in vagina. Due to underlying inflammation, the edges of the wound were quite fragile and direct homeostasis with suturing was impassible. Therefore, we used a new technique, i.e. a Gavage syringe (Ethicon) covered by a 10*20 cm Surgicel, for appropriate and effective vaginal packing to control hemorrhage. Although previous research has employed Surgicel for neovaginoplasty in patients with vaginal aplasia,^1,2 to the best of our knowledge, we were the first to use this method to manage postpartum bleeding due to vaginal laceration. After 24 hours of using this device, bleeding completely stopped and the syringe was removed while the Surgicel was still attached to the side wall of vagina.
  The patient used sit bath 3 times every day for a week.
  Gavage syringe covered by Surgicel may be useful for homeostasis in complicated obstetric vaginal lacerations when wounds are quite fragile and direct homeostasis with suturing is impassible.