Are you an attending provider (MD or DO) who is practicing on a labor and delivery floor?
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Yes
No
Are you 18 years or older?
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Yes
No
In what state are you currently practicing?
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Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
What type of practice are you currently working in?
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Solo private practice
One partner
Small group (2-3 partners)
Large group (4 or more partners)
Single specialty
Multi-group specialty
Military/government
University full-time faculty and practice
Community hospital faculty
Community hospital faculty (part-time)
Other
Solo private practice
One partner
Small group (2-3 partners)
Large group (4 or more partners)
Single specialty
Multi-group specialty
Military/government
University full-time faculty and practice
Community hospital faculty
Community hospital faculty (part-time)
Other
If other, please explain:
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Which location best describes your practice?
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Urban - inner city
Urban - non inner city
Suburban
Mid-sized town
Small town (<30,000 persons)
Rural (<5,000 persons)
Military
Tribal land or reservation
Urban - inner city
Urban - non inner city
Suburban
Mid-sized town
Small town (<30,000 persons)
Rural (<5,000 persons)
Military
Tribal land or reservation
How many years have you been practicing as an attending physician?
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< 5 years
6-10 years
11-20 years
21-30 years
31-40 years
>41 years
< 5 years
6-10 years
11-20 years
21-30 years
31-40 years
>41 years
What percentage of your work time is spent providing direct patient care?
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Less than 10%
10-29%
30-59%
60-74%
75% or more
Less than 10%
10-29%
30-59%
60-74%
75% or more
At your institution or organization, is there standardized management (i.e. care bundle, order set, algorithm, etc.) for obstetric anal sphincter injuries?
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Yes
No
If yes, please explain:
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During which steps of a third or fourth degree laceration repair do you routinely perform a rectal exam
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Prior to initiation of the repair only
Prior to initiation of the repair and following completion of the repair
Following completion of the repair only
I do not perfom rectal exams during third or fourth degree laceration repairs
Prior to initiation of the repair only
Prior to initiation of the repair and following completion of the repair
Following completion of the repair only
I do not perfom rectal exams during third or fourth degree laceration repairs
What suture do you routinely use for repair of the anal mucosa?
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Vicryl
Monocryl
Chromic
Ethilon
PDS
Other
Vicryl
Monocryl
Chromic
Ethilon
PDS
Other
If other, please explain
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What suture do you routinely use for repair of the internal anal sphincter?
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Vicryl
Monocryl
Chromic
Ethilon
PDS
Other
Vicryl
Monocryl
Chromic
Ethilon
PDS
Other
If other, please explain
* must provide value
What suture do you routinely use for repair of the external anal sphincter?
* must provide value
Vicryl
Monocryl
Chromic
Ethilon
PDS
Other
Vicryl
Monocryl
Chromic
Ethilon
PDS
Other
If other, please explain
* must provide value
What suture do you routinely use for repair of the perineal musculature (second degree)?
* must provide value
Vicryl
Monocryl
Chromic
Ethilon
PDS
Other
Vicryl
Monocryl
Chromic
Ethilon
PDS
Other
If other, please explain
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What suture do you routinely use for repair of the vaginal mucosa and perineal skin (first degree)?
* must provide value
Vicryl
Monocryl
Chromic
Ethilon
PDS
Other
Vicryl
Monocryl
Chromic
Ethilon
PDS
Other
If other, please explain
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Do you routinely administer antibiotics to patients who sustain third or fourth degree lacerations?
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Yes
No
If yes, in what scenarios do you routinely administer antibiotics to patients who sustain third or fourth degree lacerations?
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All third and fourth degree lacerations
Only fourth degree lacerations
If >50% of external anal sphincter is torn (IIIb lacerations) and fourth degree lacerations
Other
All third and fourth degree lacerations
Only fourth degree lacerations
If >50% of external anal sphincter is torn (IIIb lacerations) and fourth degree lacerations
Other
If other, please explain
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If yes, what antibiotic agent do you administer (assuming the patient has no known drug allergies)?
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A first generation cephalosporin (i.e. Ancef, Keflex)
A second generation cephalosporin (i.e. Cefoxitin, cefuroxime, or cefotetan)
Gentamycin and clindamycin
Other
A first generation cephalosporin (i.e. Ancef, Keflex)
A second generation cephalosporin (i.e. Cefoxitin, cefuroxime, or cefotetan)
Gentamycin and clindamycin
Other
If other, what antibiotic agent do you administer?
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Do you routinely administer a bowel regimen to patients who sustain third or fourth degree lacerations?
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Yes
No
If yes, when do you routinely initiate a bowel regimen on patients who sustain a third or fourth degree laceration?
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All patients within 24 hrs repair
All patients within 3 days of repair
All patients at discharge from the hospital
Only in patients who endorse difficulties with defecation following repair
Other
All patients within 24 hrs repair
All patients within 3 days of repair
All patients at discharge from the hospital
Only in patients who endorse difficulties with defecation following repair
Other
If other, please explain
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If yes, what is the bowel regimen you routinely prescribe? (please include agent and number of times per day)
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What is your routine follow up timeline for a patient who has undergone a third degree repair?
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Within 1 week of discharge (in person)
Within 1 week of discharge (televisit)
Within 2 weeks of discharge (in person)
Within 2 weeks of discharge (televisit)
Within 4 weeks of discharge (in person)
Within 4 weeks of discharge (televisit)
At routine post partum appointment 6-8 weeks after birth (televisit)
At routine post partum appointment 6-8 weeks after birth (in person)
Other
Within 1 week of discharge (in person)
Within 1 week of discharge (televisit)
Within 2 weeks of discharge (in person)
Within 2 weeks of discharge (televisit)
Within 4 weeks of discharge (in person)
Within 4 weeks of discharge (televisit)
At routine post partum appointment 6-8 weeks after birth (televisit)
At routine post partum appointment 6-8 weeks after birth (in person)
Other
If other, please explain
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What is your routine follow up timeline for a patient who has undergone a fourth degree repair?
* must provide value
Within 1 week of discharge (in person)
Within 1 week of discharge (televisit)
Within 2 weeks of discharge (in person)
Within 2 weeks of discharge (televisit)
Within 4 weeks of discharge (in person)
Within 4 weeks of discharge (televisit)
At routine post partum appointment 6-8 weeks after birth (televisit)
At routine post partum appointment 6-8 weeks after birth (in person)
Other
Within 1 week of discharge (in person)
Within 1 week of discharge (televisit)
Within 2 weeks of discharge (in person)
Within 2 weeks of discharge (televisit)
Within 4 weeks of discharge (in person)
Within 4 weeks of discharge (televisit)
At routine post partum appointment 6-8 weeks after birth (televisit)
At routine post partum appointment 6-8 weeks after birth (in person)
Other
If other, please explain
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