Repair of a median episiotomy

(A) Second-degree median episiotomy
(B) The vaginal epithelium to just outside the hymenal ring is reapproximated first.
(C) The perineal body and bulbocavernosus muscle are then reapproximated with intermittent or continuous sutures. The perineal skin can be reapproximated with a continuous running subcuticular suture.
(D) Completed repair.