Perineal wound breakdown: is it time to change our practice; a retrospective cohort study

Objective: to identify the incidence of perineal wound breakdown, to analyse potential risk factors that may contribute to perineal wound breakdown and review the management of these women in a dedicated pelvic health clinic. Design: retrospective cohort study Setting: NHS foundation trust hospital, pelvic health clinic Population: Women who sustain a perineal wound breakdown following a vaginal birth at our maternity unit Methods: All women attending the clinic between February 2017 – May 2021 with perineal wound breakdown were included. Demographics, management and postnatal symptoms were collected. Data was accessed through electronic patient records and descriptive analysis of the data were undertaken. Main outcome measures: rate of perineal wound breakdown in our unit, success of surgical management of perineal wound breakdown. Results: Over the 4 year period, 231 women attended the dedicated perineal clinic with perineal wound breakdown, a perineal dehiscence rate of 1.5% of all perineal trauma. Of these women, 41 had secondary re-suturing, with the rest managed expectantly. Conclusions: We found a low incidence of perineal wound breakdown in our unit and of those women who were re-sutured, the technique appears appropriate as only one woman had a further perineal wound breakdown. The dedicated perineal clinic is a positive service for women who deliver at our maternity unit, as this facilitates a unit to monitor changes in physical birth trauma and allow timely and patient centred intervention. Funding: no funding for this study Keywords: perineal wound breakdown, perineal clinic