Steen and Cooper developed a categorical scale for evaluating perineal trauma associated with episiotomy or laceration associated with delivery. This is intended to be simpler and less intrusive to perform than the REEDA scale. It can be used to assess the injury and monitor healing. The authors are from Leeds in England.
Edema and Redness
Bruising (Ecchymosis)
Grade
no swelling, no redness
no bruising
none
any tissue swelling <= 1 cm from incision, or slight redness
any slight bruising (pale purple) <= 1 cm from incision
mild
any tissue swelling < 2 cm from incision, and slight redness
any deep bruising (purple) <= 2 cm from incision
moderate
any tissue swelling >= 2 cm from incision; marked redness
any deep bruising (purple) > 2 cm from incision
severe
after Figure 4, page 435.
where:
• For severe edema and redness, I will implement it as tissue swelling OR marked redness.
• In assigning grade, I will implement as edema/redness OR bruising.
• The use of "up to" in the measurements might cause some confusion at the breakpoints. Edema is measured up to 2 cm or >= 2 cm; bruising is measured up to 2 cm or > 2 cm. Go figure.
• The little finger can be used instead of a tape measure to make the measurements. The authors assumed that it was "about" 1 cm in diameter.
Photographs to aid in the clinical assessment are given in Figure 2 (page 434) and Figure 3 (page 435).
To read more or access our algorithms and calculators, please log in or register.
