Data collection and measurements
perineum, ®, itching, hyperemia, pain, ecchymosis, hematoma, tissue damage, oedema, trauma
ALLERGIC REACTION, HYPEREMIA, WOUND INFECTION, RECRUITMENT, COMPLICATIONS, ECCHYMOSIS, HEMATOMA, OEDEMA
The data were collected from March 2017 to September 2018 in six stages: stage 1: during labour and up to 2 h after the perineal repair procedure; stage 2: from 12 to 24 h postpartum; stage 3: from 36 to 48 h; stage 4: from 10 to 20 days; stage 5: from 50 to 70 days; and stage 6: from 6 to 8 months.A form for the interview and data recording was explicitly developed for this research, which contained the following baseline characteristics: maternal age, ethnicity, schooling level, occupation, marital status, nutritional status, parity, gestational age, body mass index (BMI), newborn weight, and the outcomes variables. A pre-test was conducted to evaluate the form and the procedures that would be done during data collection.As a first step, the researchers presented the study to professionals working in the service in order for them to accept, collaborate and integrate themselves into the research. During the recruitment, the researchers visited the study locus daily to locate the women who met the study's eligibility and inclusion criteria. The eligible women were invited to participate in the study when hospitalised.Aiming to avoid bias in the data, the classification of the perineal trauma and the evaluation regarding the need for the repair procedure was in charge by the nurse-midwives of the birth centre, who were not part of the research team. Nevertheless, the nurse-midwives of the research team were in charge of the perineal repair procedure. Both groups used a digital stopwatch to measure the perineal repair time.The professionals were asked to prescribe analgesics or anti-inflammatory medications if the puerperal women complained about pain so that perineal pain intensity could be better assessed. The participating women were instructed to request pain medications anytime they needed them. A medical evaluation was requested in case of complications related to the perineal repair procedure in the women from any research group.In order to assess perineal pain intensity, the women were handed in the Visual Numeric Scale (VNS) to visualise and indicate the number corresponding to pain intensity. VNS consists of a horizontal line with values expressed in centimetres from 0 to 10, where zero is the total absence of pain and ten represents the worst pain possible [The perineum healing process was evaluated using the REEDA scale in stages 1 and 4 of the study. The scale is indicated to evaluate the tissue recovery process after perineal trauma through five healing items: Each item evaluated was assigned a score from 0 to 3, where the maximum score (15) corresponds to the worst possible perineum healing result [A Peri-Rule® ruler was used to measure hyperemia, oedema, ecchymosis and coaptation of the edges [In addition to the items on the REEDA scale, the researchers evaluated any other tissue damage or morbidity related to perineal repairs, such as hematoma, itching, wound infection, or allergic reaction.Given the nature of the interventions and outcomes, there was no possibility of blinding, as both the women and the researchers were aware of the type of perineal repair performed and because, in the evaluation of the healing process, it is possible to see whether glue or suture thread was used.