PERINEAL CARE

Perineal Care

 Perineal area (perinium) is the region between the thighs, bounded by the scrotum and anus in males and by the
opening of the vagina and the anus in females
 Female perineum is a diamond-shaped structure inferior to the pelvic diaphragm and between the symphysis
pubis and coccyx
 During a typical vaginal delivery, the skin of your vagina prepares for childbirth by thinning out; this part of your
body is meant to stretch and allow the baby’s head and body to pass through without trauma
 It involves washing the external genitalia with soap and water or with water alone or in combination with any
commercially prepared peri wash
 Can be delegated to nursing assistive personnel
 Because this area is prone to infection, it must be cleaned at least daily, and more if your loved one suffers from
incontinence
 Proper perineal care allows for inspection of the skin; it keeps the perineal area clean and less likely to break
down; it also decreases the risk for urinary tract infections
 Perineal care is carried out of the patient’s bath or as a separate procedure
 It is conductive to the growth of pathogenic organism because it is warm, moist and is not well ventilated

Purpose of Perineal Care

 Prevent eliminate infection, odor and promote healing

 Remove secretions, and provide comfort

Principles of Perineal Care

1. To clean the perineum from the cleanest to the less clean area
2. Maintain patient’s privacy
3. Follow standard precautions
4. Proximal level of functioning or the range of abilities an individual can perform with the guidance of an expert

Why is Perineal Care important before delivery?

Perineal care will help perineum heal faster, feel better, and help prevent infection. It needs to continue doing perineal
care for 1 to 3 weeks after giving birth.

Procedure

1. Assemble supplies and provide for privacy

2. Explain the procedure to the patient, perform hand hygiene, and put on disposable gloves
3. Wash and rinse the groin area (both male and female patients)

Female patient

 Spread labia and move the washcloth from the pubic area toward the anal area to prevent carrying
organisms from the anal area back over the genital area
 Always proceed from the least contaminated area to the most contaminated area. Use a clean portion of the
washcloth for each stroke
 Rinse the washed areas well with plain water

Male patient

 Clean the tip of the penis first, moving the washcloth in a circular motion from the meatus outward
 Wash the shaft of the penis using downward strokes toward the pubic area
  Always proceed from the least contaminated area to the most contaminated area
 Rinse the washed areas well with plain water. In an uncircumcised male patient (teenager or older), retract
the foreskin (prepuce) while washing the penis
 Pull the uncircumcised male patient’s foreskin back into place over the glans penis to prevent constriction of
the penis, which may result in edema and tissue injury
 It is not recommended to retract the foreskin for cleaning during infancy and childhood, because the injury
and scarring could occur
 Wash and rinse the male patient’s scrotum. Handle the scrotum, which houses the testicles, with care
because the area is sensitive
4. Dry the cleaned areas and apply an emollient as indicated. Avoid the use of powered. Powder may become a
medium for the growth of bacteria.
5. Turn the patient on his or her side and continue cleansing the anal area
 Continue in the direct of least contaminated to most contaminated area
 In the female, cleanse from the vagina toward the anus
 In both female and male patients, change the washcloth with each stroke until the area is clean
 Rinse and dry the area.
6. Remove gloves and perform hand hygiene. Continue with additional care as necessary

What is Perineal Preparation?

Perineal preparation is similar to perineal massage

Perineal Preparation Perineal Massage

Helps mother in labor how to relax into the natural Gentle, manual stretching of the pelvic floor to prepare
opening of the vagina during childbirth and how to the muscles and skin between vagina and rectum for the
become accustomed to these sensations birth of the baby. The goal is to reduce the risk of tearing
and scarring during delivery

Vaginal Preparation

Simple cleansing the vagina with pevidone-iodine antiseptic or cleanser before spontaneous vaginal delivery

 Cleansing the vagina with povidone-iodine or chlorhexidine solution (compared to saline or not cleansing)
immediately before vaginal delivery may reduces the risk of infection of the uterus, fever, and infection of the
surgical wound
Procedure Checklist

Perineal Care

PROCEDURES
1. Explain to the client what you are going to do, why is it necessary and how he can cooperate
2. Wash hands and observe other, appropriate infection control procedure
3. Provide for client privacy
4. Prepare all equipment needed
 Kelly’s pad
 Rubber sheet
 Drape
 Betadine cleanser
 Betadine antiseptic
 Pail (bucket)
 Ovum forceps
 Cherries (1 cherry/stroke)
 NSS solution
 Sterile gloves
5. Place client in a lithotomy position
6. Properly drape the client to prevent unnecessary exposure
7. Put on gloves
8. Ask the client to lift her buttocks and place the Kelly pad properly
9. With one hand, pour NSS solution over the perineal area
10. Initially clean the perineum using cherries with betadine cleanser
Observe outward stroke from cleanest to dirtiest area (1-7-7 stroke)
11. Extend cleansing up to the upper inner thighs
12. Rinse the area with NSS solution
13. Clean the perineum using antiseptic solution
14. Ensure the client’s comfort and perform hand washing post procedure
15. Document relevant information