Prevalence, pathophysiology and current management of dehisced perineal wounds following childbirth

Abstract

Each year, approximately 60 to 70% of women in the UK experience perineal suturing following childbirth, which equates to approximately 1000 women per day. the majority of sutured perineal wounds will heal fairly quickly by primary intention with minimal morbidity. However, for those women whose perineal wound dehisces (breaks down), the healing process takes considerably longer and is associated with increased morbidity. the exact incidence of perineal wound dehiscence is currently unknown; figures of 0.1% to 5.5% have been reported. a large proportion of dehisced wounds are managed expectantly (left to heal by secondary intention) whereas some are re-sutured during the early postpartum period. Currently, the management of dehisced wounds varies according to individual practitioner’s preferences and hospital policy as there are no robust research evidence or clear guidelines to inform best practice.