TY - JOUR

T1 - Perineal resuturing versus conservative treatment for dehisced perineal wounds and episiotomies

T2 - a systematic review and meta-analysis

AU - Kullab, Ulla Bismark

AU - Moestrup, Lærke Vinberg

AU - Bergholt, Thomas

AU - Klarskov, Niels

AU - Jangö, Hanna

N1 - Publisher Copyright: © 2023, The International Urogynecological Association.

PY - 2023

Y1 - 2023

N2 - Introduction and hypothesis: Perineal wound dehiscence is associated with complications, such as infections, perineal pain, dyspareunia, and altered sexual function, that severely affects women’s health. Currently, few studies have examined secondary repair of first- and second-degree perineal wound dehiscence and episiotomies, and there is currently no consensus on the optimal treatment option for dehisced perineal wounds. The objective was to evaluate whether resuturing or conservative treatment of first- and second-degree dehisced perineal wounds and episiotomies is the optimal treatment modality in terms of postoperative healing time and other secondary outcomes. Methods: A systematic literature search was carried out using PubMed, Embase, and Cochrane databases. All included studies were evaluated using the SIGN methodology checklist, with the purpose of assessing the study quality. Results: Three randomized controlled trials were included. Only two small sample-sized studies presented data regarding healing time for both the resuturing and the conservative treatment groups. However, no significant difference was found between the two groups at 4–6 weeks’ healing time (RR 1.16, 95% CI 0.53–2.52). One study found that women being resutured experienced a significantly reduced healing time and higher satisfaction with the appearance of the wound healing at 3 months compared with the conservative treatment group. Conclusion: We found no significant differences in the healing time between the resuturing group and the conservative treatment group. However, the sample sizes of the studies were small. A well-designed, large, and prospective randomized controlled trial is needed to evaluate the optimal treatment modality for dehisced perineal wounds.

AB - Introduction and hypothesis: Perineal wound dehiscence is associated with complications, such as infections, perineal pain, dyspareunia, and altered sexual function, that severely affects women’s health. Currently, few studies have examined secondary repair of first- and second-degree perineal wound dehiscence and episiotomies, and there is currently no consensus on the optimal treatment option for dehisced perineal wounds. The objective was to evaluate whether resuturing or conservative treatment of first- and second-degree dehisced perineal wounds and episiotomies is the optimal treatment modality in terms of postoperative healing time and other secondary outcomes. Methods: A systematic literature search was carried out using PubMed, Embase, and Cochrane databases. All included studies were evaluated using the SIGN methodology checklist, with the purpose of assessing the study quality. Results: Three randomized controlled trials were included. Only two small sample-sized studies presented data regarding healing time for both the resuturing and the conservative treatment groups. However, no significant difference was found between the two groups at 4–6 weeks’ healing time (RR 1.16, 95% CI 0.53–2.52). One study found that women being resutured experienced a significantly reduced healing time and higher satisfaction with the appearance of the wound healing at 3 months compared with the conservative treatment group. Conclusion: We found no significant differences in the healing time between the resuturing group and the conservative treatment group. However, the sample sizes of the studies were small. A well-designed, large, and prospective randomized controlled trial is needed to evaluate the optimal treatment modality for dehisced perineal wounds.

KW - Episiotomy

KW - First-degree perineal tear

KW - Resuturing of perineal wounds

KW - Second-degree perineal tear

KW - Vaginal delivery

KW - Wound dehiscence

U2 - 10.1007/s00192-023-05642-x

DO - 10.1007/s00192-023-05642-x

M3 - Review

C2 - 37740731

AN - SCOPUS:85172021384

VL - 34

SP - 2859

EP - 2866

JO - International Urogynecology Journal

JF - International Urogynecology Journal

SN - 0937-3462

IS - 12

ER -