1. Proximate the deep tissues of the perineal body by placing 3-4 interrupted 2-O or 3-O chromic or Vicryl absorbable sutures. Reapproximate the superficial layers of the perineal body with a running suture extending to the bottom of the episiotomy.

2. Identify the apex of the vaginal laceration. Suture the vaginal mucosa with running, interlocking, 3-O chromic or Vicryl absorbable suture.

3. Close the perineal skin with a running, subcuticular suture. Tie off the suture and remove the needle.

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