Summary

Summary

The Episcissors‑60 are surgical scissors used for episiotomy, and are designed to achieve a mediolateral cut at 60 degrees to the perineal midline to minimise the risk of obstetric anal sphincter injuries. One comparative study and 2 non‑comparative studies comprising a total of 105 women reported that the Episcissors‑60 successfully cut at the intended 60‑degree angle and produced a post‑delivery suture angle of 30–60 degrees. One study reported high user satisfaction among obstetrics trainees using the device. Each reusable Episcissors‑60 costs £400 excluding VAT.

Likely place in practice

  • The Episcissors‑60 are designed to guide an accurate mediolateral episiotomy at 60 degrees to the perineal midline. They provide an alternative to standard episiotomy scissors, for which the cutting angle must be estimated.

  • They would be used in secondary care midwifery and obstetric units, primary care midwifery units or birth centres and during home births. Both straight and angled versions are available.

Effectiveness and safety

  • The evidence base for Episcissors is currently limited to 1 small comparative study and 2 non‑comparative case series. All studies had methodological limitations.

  • One study (n=63) compared the angled version of Episcissors‑60 with the Braun‑Stadler scissors and demonstrated a clear difference of 12 degrees in post‑delivery suture angles achieved. One case of obstetric anal sphincter injury was reported in the Braun‑Stadler group and none was reported in the Episcissors‑60 group.

  • One study (n=25) investigated the use of the angled version of Episcissors‑60 and reported an average post‑delivery suture angle of 50 degrees. No cases of obstetric anal sphincter injuries were reported.

  • One study (n=17) investigated a prototype of the straight version of Episcissors‑60 and reported a mean post‑delivery suture angle of 42.4 degrees. One patient who had a sequential ventouse‑forceps delivery experienced a grade 3a obstetric anal sphincter injury.

Technical factors

  • The Episcissors‑60 are intended for use by qualified midwives and obstetricians trained in mediolateral episiotomy.

  • Two types of Episcissors‑60 are available: a straight version and an angled version.

  • Episcissors are designed for right‑handed use only.

  • One study reported that 88% of the obstetric trainees agreed or strongly agreed that the Episcissors‑60 were easy to use. However, 1 left‑handed user had difficulty using the device.

Cost and resource use

  • The list price of Episcissors‑60 is £400 excluding VAT. The device is reusable after standard decontamination processes.

  • No published evidence was identified on the costs of adopting the technology or resource consequences.