Healing of disrupted perineal wounds after vaginal delivery: a poorly understood condition

2021 ◽  
Vol 30 (Sup20) ◽  
pp. S8-S16
Author(s):  
Nicola Adanna Okeahialam ◽  
Ranee Thakar ◽  
Abdul H Sultan
Keyword(s):  
Wound Healing ◽  
Wound Infection ◽  
Vaginal Delivery ◽  
Perineal Pain ◽  
Maternity Services ◽  
Perineal Injury ◽  
Management Of Complications ◽  
Perineal Wounds

Perineal injury following childbirth can result in complications such as wound infection and dehiscence. The reported incidence of these complications in the literature range between 0.1-23.6% and 0.2-24.6%, respectively. However, the healing of disrupted perineal wounds is poorly understood. In addition, it is a neglected area in maternity services. In this review, the authors explore the process of wound healing in the context of infected perineal wounds following childbirth. In addition, the authors describe the management of complications including hypergranulation, perineal pain and dyspareunia.

scholarly journals Selective episiotomy versus no episiotomy – A clinical study on primigravida

2021 ◽  
Vol 12 (8) ◽  
pp. 81-87
Author(s):  
Joydip Neogi ◽  
Rahul Chaudhuri ◽  
Swarna Nandi ◽  
Ranita Roy Chowdhury ◽  
Manidip Pal
Keyword(s):  
Longitudinal Study ◽  
Clinical Study ◽  
Wound Infection ◽  
Vaginal Delivery ◽  
External Genitalia ◽  
Maternal Outcome ◽  
Perineal Pain ◽  
Inclusion Criteria

Background: Episiotomy is the incision given over the pudendum, i.e. on the external genitalia organ during the vaginal delivery. Aims and Objective: In this study it has been tried to evaluate the benefits and the risks of selective episiotomy over spontaneous lacerations. Materials and Methods: This is an institution based interventional longitudinal study carried out in the Department of Obstetrics & Gynaecology of College Of Medicine & JNM Hospital, Kalyani over a period of 18 months in 218 patients (109 in each group) fulfilling the inclusion criteria. The recruitment and allocation in episiotomy and non-episiotomy groups were random after proper consent from the participants. Results: The frequency of postpartum perineal pain was around 47% in no episiotomy group and around 60% in selective episiotomy group. There were no cases of dehiscence, haematoma or wound infection in either of the groups. Around 96.22% of the women in the non-episiotomy group were satisfied or very satisfied compared to 89.52% in the selective episiotomy group. Conclusion: An episiotomy rate of less than 1% found in no episiotomy group as compared to around 18% episiotomy rate in selective episiotomy group. However, they have almost same feto-maternal outcome which successfully establish the effectiveness of no episiotomy practice over the selective one.

PENGARUH SITZ BATH AIR HANGAT TERHADAP LAMA PENYEMBUHAN LUKA PERINEUM PADA IBU POST PARTUM DI PMB PONIRAH KOTA METRO

2019 ◽  
Vol 8 (1) ◽  
pp. 27-32
Author(s):  
Martini Martini ◽  
Yetti Anggraini
Keyword(s):  
Wound Healing ◽  
Post Partum ◽  
Perineal Wound ◽  
Perineal Pain ◽  
Sitz Bath ◽  
Perineal Wound Healing ◽  
Accelerate Wound Healing ◽  
Perineal Wounds ◽  
Postpartum Mothers ◽  
The Impact

Background: Tearing a perineal wound during labor usually occurs so that the baby's head can be born quickly. Perineal wounds can be due to spontaneous tears or because of an episiotomy. The incidence of perineal rupturein PMB Ponirah as much as 69% 65% of mothers trip advisor perineal wounds. The impact of perineal rupture can cause pain. Objective:  The purpose of this study was to determine the effect of warm baths on the wounds experienced by postpartum mothers in PMB Ponirah Metro City District. Methods: This study is a pre-experimental quantitative study with the Static Group Comparison design. The large sample consisted of 30 people, consisting of 15 people as sizt bath and 15 people as not sizt bath. In this study used the Mann Whitney test. Results: The results of the study showed the average reserve of bath sitz on day 5 and there was no reserve for bathing sitz on the 7th day. The result of the effect is the effect of warm baths on the duration of perineal wound healing in postpartum mothers. Conclusion: Sitz bath can accelerate wound healing and help with perineal pain.   Keywords: Perineal pain, Perineal wound healing,Sitz bath

scholarly journals PENGARUH SITZ BATH AIR HANGAT TERHADAP LAMA PENYEMBUHAN LUKA PERINEUM PADA IBU POST PARTUM DI PMB PONIRAH KOTA METRO

2019 ◽  
Vol 8 (1) ◽  
pp. 27-32
Author(s):  
Martini ◽  
Yetti Anggraini
Keyword(s):  
Wound Healing ◽  
Post Partum ◽  
Perineal Wound ◽  
Perineal Pain ◽  
Sitz Bath ◽  
Perineal Wound Healing ◽  
Accelerate Wound Healing ◽  
Perineal Wounds ◽  
Postpartum Mothers ◽  
The Impact

Background: Tearing a perineal wound during labor usually occurs so that the baby's head can be born quickly. Perineal wounds can be due to spontaneous tears or because of an episiotomy. The incidence of perineal rupturein PMB Ponirah as much as 69% 65% of mothers trip advisor perineal wounds. The impact of perineal rupture can cause pain. Objective: The purpose of this study was to determine the effect of warm baths on the wounds experienced by postpartum mothers in PMB Ponirah Metro City District. Methods: This study is a pre-experimental quantitative study with the Static Group Comparison design. The large sample consisted of 30 people, consisting of 15 people as sizt bath and 15 people as not sizt bath. In this study used the Mann Whitney test. Results: The results of the study showed the average reserve of bath sitz on day 5 and there was no reserve for bathing sitz on the 7th day. The result of the effect is the effect of warm baths on the duration of perineal wound healing in postpartum mothers. Conclusion: Sitz bath can accelerate wound healing and help with perineal pain. Keywords: Perineal pain, Perineal wound healing,Sitz bath

Neonatal Intravenous Extravasation Injuries: Evaluation of a Wound Care Protocol

2006 ◽  
Vol 25 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Doris Sawatzky-Dickson ◽  
Karen Bodnaryk
Keyword(s):  
Wound Healing ◽  
Birth Weight ◽  
Wound Infection ◽  
Gestational Age ◽  
Wound Care ◽  
Systemic Infection ◽  
Coagulase Negative Staphylococcus ◽  
Evidence Based ◽  
Infection Rates ◽  
Care Protocol

Purpose:To evaluate an evidence-based wound protocol for intravenous extravasation injuries in neonates.Sample:Nine newborns with intravenous extravasation injuries. Birth weight: 582–4,404 gm, gestational age: 24–40 weeks.Results:Five wounds were colonized with coagulase-negative Staphylococcus species, two with diphtheroids, three with Enterococcus. There was no evidence of wound infection or systemic infection. Rates of wound healing ranged from one to six weeks.

Management of Deep Spinal Wound Infections Following Instrumentation Surgery with Subfascial Negative Pressure Wound Therapy

2021 ◽  
Author(s):  
Marcus Rickert ◽  
Michael Rauschmann ◽  
Nizar Latif-Richter ◽  
Mohammad Arabmotlagh ◽  
Tamin Rahim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Wound Healing ◽  
Wound Infection ◽  
Spinal Fusion ◽  
Negative Pressure Wound Therapy ◽  
Wound Infections ◽  
Wound Therapy ◽  
Postoperative Wound ◽  
Deep Wound ◽  
The Impact

Abstract Background and Study Aims The treatment of infections following a spine surgery continues to be a challenge. Negative pressure wound therapy (NPWT) has been an effective method in the context of infection therapy, and its use has gained popularity in recent decades. This study aims to analyze the impact of known risk factors for postoperative wound infection on the efficiency and length of NPWT therapy until healing. Patients and Methods We analyzed 50 cases of NPWT treatment for deep wound infection after posterior and posteroanterior spinal fusion from March 2010 to July 2014 retrospectively. We included 32 women and 18 men with a mean age of 69 years (range, 36–87 years). Individual risk factors for postoperative infection, such as age, gender, obesity, diabetes, immunosuppression, duration of surgery, intraoperative blood loss, and previous surgeries, as well as type and onset (early vs. late) of the infection were analyzed. We assessed the associations between these risk factors and the number of revisions until wound healing. Results In 42 patients (84%), bacterial pathogens were successfully detected by means of intraoperative swabs and tissue samples during first revision. A total of 19 different pathogens could be identified with a preponderance of Staphylococcus epidermidis (21.4%) and S. aureus (19.0%). Methicillin-resistant S. aureus (MRSA) was recorded in two patients (2.6%). An average of four NPWT revisions was required until the infection was cured. Patients with infections caused by mixed pathogens required a significantly higher number of revisions (5.3 vs. 3.3; p < 0.01) until definitive wound healing. For the risk factors, no significant differences in the number of revisions could be demonstrated when compared with the patients without the respective risk factor. Conclusion NPWT was an effective therapy for the treatment of wound infections after spinal fusion. All patients in the study had their infections successfully cured, and all spinal implants could be retained. The number of revisions was similar to those reported in the published literature. The present study provides insights regarding the effectiveness of NPWT for the treatment of deep wound infection after spinal fusion. Further investigations on the impact of potential risk factors for postoperative wound healing disorders are required. Better knowledge on the impact of specific risk factors will contribute to a higher effectiveness of prophylaxis for postoperative wound infections considering the patient-specific situation.

Perineal Injury and Its Association with Postpartum Sexual Dysfunction among First Delivery Women

2021 ◽  
Vol 2 (3) ◽  
pp. 34-39
Author(s):  
Z. Nusee ◽  
M. N. Ainy ◽  
P. Hafizah
Keyword(s):  
Sexual Dysfunction ◽  
Vaginal Delivery ◽  
Female Sexual Dysfunction ◽  
Family Income ◽  
Mode Of Delivery ◽  
Sexually Active ◽  
Perineal Tear ◽  
Health Clinics ◽  
Perineal Injury ◽  
Significant Difference

Background: Female sexual dysfunction (FSD) following childbirth imposes significant burden to the marital institution around the world. The perineal injury may potentially be one of the main risk factors contributing to postpartum female sexual dysfunction (PPFSD). The study aimed to determine the effect of perineal injury and patients’ characteristics on PPFSD. Methodology: This cross-sectional questionnaire study was conducted in six different health clinics in the district of Kuantan from April 2019 to October 2019. Eligible women who came to the family health clinics at 6 months postpartum were recruited as study population. The participants completed their biodata and socio-demographic form and the Malay-validated Female Sexual Function Index (MVFSFI) questionnaire given. A cut-off point of 26.55 and below on MVFSFI scoring system was used as a measure of the primary outcome of sexual dysfunction. Results: Out of 240 women who delivered vaginally, 34 (14%) had intact perineum, 107 (44.6%) sustained 1st degree perineal tear, 96 (40%) 2nd degree tear and three (1.25%) 3rd degree tear. Among the respondents, 60.9% of the sexually active respondents who had vaginal delivery, reported to have PPFSD. The timing of sexual resumption does not correlate with the severity of perineal tear. The severity of perineal tear is significantly associated with age (p=0.018), duration of marriage (p=0.008), body mass index (BMI) (p=0.019) and instrumental delivery (p=0.025). The level of personnel skill whom performed the repair were also found to have a significant relationship to PPFSD (p= 0.001). The relationship of participants’ mean age (p=0.271), marriage duration (p=0.903), race (p=0.928), religion (p=0.852), education level (p=0.549), employment status (p=0.102), family income (p=0.460) and BMI(p=0.159) with presence of PPFSD were all found to be statistically not significant. Conclusion: Occurrence of PPFSD is high among sexually active women who had vaginal delivery complicated by perineal tear, especially among those requiring instrumentation. The severity of perineal tear is associated with age, duration of marriage, BMI and mode of delivery. However, PPFSD does not significantly relate to the severity of perineal tear. None of the socio-demographic factors show a significant difference to sexual dysfunction.

A renewed look at silver dressings for wound infections: Ag Oxysalts technology

2021 ◽  
Vol 26 (Sup9) ◽  
pp. S26-S36
Author(s):  
Luxmi Dhoonmoon ◽  
Hayley Turner-Dobbin ◽  
Karen Staines
Keyword(s):  
Wound Healing ◽  
Wound Infection ◽  
Case Studies ◽  
Healing Process ◽  
Systemic Toxicity ◽  
Wound Healing Process ◽  
Wound Infections ◽  
Infected Wounds ◽  
Long Time

Wound infection is an important complicating factor in the wound healing process, and infections can be even more complex and difficult to manage in the case of wounds with biofilms. Silver has been used to treat infected wounds for a long time now, and the strength of the product depends on the number of Ag ions, where the greater the number of ions, the higher and faster the reactivity is. Ag Oxysalts technology—used in 3M Kerracontact Ag dressing—has three times more ions than standard silver dressings. The technology also does not show the typical disadvantages of silver, such as cytotoxicity and systemic toxicity. This article discusses the use of Ag Oxysalts technology for infected wounds and presents case studies to support the efficacy of this product in promoting wound healing.

scholarly journals Photo-Crosslinked Polymeric Matrix with Antimicrobial Functions for Excisional Wound Healing in Mice

Nanomaterials ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. 791 ◽  
Author(s):  
Ming-Hsiang Chang ◽  
Yu-Ping Hsiao ◽  
Chia-Yen Hsu ◽  
Ping-Shan Lai
Keyword(s):  
Wound Healing ◽  
Wound Infection ◽  
Polymer Solution ◽  
Wound Dressing ◽  
Glycol Diacrylate ◽  
Excisional Wound ◽  
Poly Ethylene ◽  
Systemic Infections

Wound infection extends the duration of wound healing and also causes systemic infections such as sepsis, and, in severe cases, may lead to death. Early prevention of wound infection and its appropriate treatment are important. A photoreactive modified gelatin (GE-BTHE) was synthesized by gelatin and a conjugate formed from the 3,3′,4,4′-benzophenone tetracarboxylic dianhydride (BTDA) and the 2-hydroxyethyl methacrylate (HEMA). Herein, we investigated the photocurable polymer solution (GE-BTHE mixture) containing GE-BTHE, poly(ethylene glycol) diacrylate (PEGDA), chitosan, and methylene blue (MB), with antimicrobial functions and photodynamic antimicrobial chemotherapy for wound dressing. This photocurable polymer solution was found to have fast film-forming property attributed to the photochemical reaction between GE-BTHE and PEGDA, as well as the antibacterial activity in vitro attributed to the ingredients of chitosan and MB. Our in vivo results also demonstrated that untreated wounds after 3 days had the same scab level as the GE-BTHE mixture-treated wounds after 20 s of irradiation, which indicates that the irradiated GE-BTHE mixture can be quickly transferred into artificial scabs to protect wounds from an infection that can serve as a convenient excisional wound dressing with antibacterial efficacy. Therefore, it has the potential to treat nonhealing wounds, deep burns, diabetic ulcers and a variety of mucosal wounds.

scholarly journals Perineal trauma after vaginal delivery in healthy pregnant women

2014 ◽  
Vol 132 (4) ◽  
pp. 231-238 ◽  
Author(s):  
Larissa Santos Oliveira ◽  
Luiz Gustavo Oliveira Brito ◽  
Silvana Maria Quintana ◽  
Geraldo Duarte ◽  
Alessandra Cristina Marcolin
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Standing Position ◽  
Professional Activity ◽  
Factors Associated ◽  
Perineal Injury ◽  
Secondary Hospital ◽  
Perineal Injuries

CONTEXT AND OBJECTIVE:Despite all the medical care provided during delivery labor, perineal injury is still prevalent and may lead to diverse pelvic floor disorders. The aim here was to investigate the prevalence of obstetric and anal sphincter injuries (OASIS) in healthy pregnant women after vaginal delivery.DESIGN AND SETTING:Cross-sectional study involving 3,034 patients with singletons in a secondary hospital for low-risk cases.METHODS:A standardized questionnaire was prepared and applied to medical files that had been completely filled out (classification of the Royal College of Obstetricians and Gynecologists, RCOG) in order to identify OASIS and analyze risk factors associated with mild and severe perineal lacerations.RESULTS:The women's mean age was 25 years; more than half (54.4%) were primiparae. Almost 38% of the participants had perineal lacerations; these were severe in 0.9% of the cases. Previous vaginal delivery (odds ratio, OR: 1.64 [1.33-2.04]) and forceps delivery (OR: 2.04 [1.39-2.97]) were risk factors associated with mild perineal injuries (1st and 2nd OASIS classifications). Only remaining standing for prolonged periods during professional activity (OR: 2.85 [1.34-6.09]) was associated with severe perineal injuries.CONCLUSION:The prevalence of severe perineal injuries was concordant with data in the literature. The variable of standing position was considered to be a risk factor for severe perineal injury and should be further investigated.

scholarly journals PENGARUH AIR REBUSAN DAUN BINAHONG DALAM MEMPERCEPAT PENYEMBUHAN LUKA PERINEUM MASA NIFAS

2021 ◽  
Vol 8 (1) ◽  
pp. 15-23
Author(s):  
Rinni Gusnimar ◽  
Nora Veri ◽  
Cut Mutiah
Keyword(s):  
Wound Healing ◽  
Wound Care ◽  
Complementary Therapy ◽  
Control Group ◽  
P Value ◽  
Control Group Design ◽  
Group Design ◽  
Quasi Experimental ◽  
Perineal Wounds ◽  
Postpartum Mothers

Infeksi nifas menjadi salah satu penyebab kematian ibu di negara berkembang termasuk Indonesia. Beberapa penyebab pemicu terjadinya infeksi nifas seperti pelayanan kebidanan, daya tahan tubuh, perawatan nifas, gizi, anemia dan kebersihan genetalia. Pada masa nifas penting untuk merawat luka perineum karena kuman bisa masuk melalui luka bekas jahitan pada perineum agar tidak menyebabkan infeksi. Salah satu alternatif terapi nonfarmakologis yang dapat digunakan untuk penyembuhan luka perineum masa nifas adalah daun binahong. Tujuan penelitian ini menguji pengaruh daun binahong dalam mempercepat penyembuhan luka perineum pada masa nifas. Penelitian ini menggunakan rancangan quasi experimental dengan pendekatan posttest only control group design. Posttest only control group design merupakan pengumpulan data dilakukan sesudah perlakuan. Total sampel yang digunakan dalam penelitian ini adalah 32 orang ibu nifas sesuai dengan kriteria inklusi. Data diobservasi berupa derajat kesembuhan luka perineum dengan menggunakan instrumen lembar observasi penyembuhan luka perineum pada skala REEDA (Redness, Edema, Ecchymosis, Discharge dan Approximation). Hasil penelitian menunjukan terdapat pengaruh pemberian rebusan Daun binahong terhadap penyembuhan luka perineum pada ibu nifas. Rerata hasil uji Uji statistik Mann Whitney, pada kelompok perlakuan adalah 11,83 lebih rendah dibandingkan pada kelompok kontrol, yaitu 21,8 (p-value = 0,001). Penelitian ini menunjukan bahwa ada pengaruh pemberian rebusan daun binahong mampu mempercepat penyembuhan luka perineum dibandingkan iodine povidone 10%. Daun binahong dapat menjadi alternatif terapi komplementer pada ibu nifas yang mengalami luka robekan perineum.   One of the main causes of maternal death in developing countries is puerperal infection. Midwifery care, body immunity, postnatal care, nutrition, anemia and genetalia hygiene are factors that trigger puerperal infections. The perineal rupture if not treated properly will cause an infection in the suture wound in the perineum. Wound care is important because germs can enter through the suture marks on the perineum and cause infection. Non-pharmacological therapies that can be used to accelerate wound healing are Anredera cordifolia. The research design was quasi experimental with posttest approach Only Control Group Design, namely data collection was done after treatment. The total sample was 32 postpartum mothers according to inclusion criteria. The data observed in this study were the degree of healing of perineal wounds using the REEDA scale perineal wound healing observation sheet instrument (Redness, Edema, Ecchymosis, Discharge and Approximation). Based on the results of the Mann Whitney test, the mean rank of the results in the treatment group was 11.83 lower than the control group, namely 21.8 (p-value = 0.001). Effect of giving Anredera cordifolia leaves on the healing of perineal wounds in postpartum mothers significantly. Care with giving Anredera cordifolia leaves can accelerate the healing of perineal wounds compared to 10% iodine povidone. Anredera cordifolia leaves can be used as a complementary therapy for postpartum mothers who experience perineal torn wounds.

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