Vacuum-Assisted Closure for Episiotomy Dehiscence.
Emeline M Aviki1, Rebecca Posthuma Batalden, Marcela G Del Carmen
1Vincent Obstetrics and Gynecology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts.
Obstetrics and Gynecology
|April 30, 2015
Summary
Vacuum-assisted closure effectively treated a severe episiotomy breakdown, a complex vulvovaginal defect. This method expedited wound healing in an outpatient setting, offering a new approach for postpartum care.
Area of Science:
- Obstetrics and Gynecology
- Surgical Wound Management
Background:
- Episiotomy dehiscence can lead to extensive vulvovaginal defects.
- Such defects are often unsuitable for immediate or delayed primary surgical closure.
Observation:
- A 26-year-old woman experienced complete episiotomy breakdown 5 days postpartum.
- The wound involved the perineum, vagina, and ischiorectal fossa with poor tissue quality.
- Traditional closure methods were not feasible due to the wound's complexity.
Findings:
- Vacuum-assisted closure (VAC) therapy was employed as an alternative to conventional wound management.
- The VAC device successfully closed the complex wound after 11 days of treatment.
- This approach facilitated healing in a challenging clinical scenario.
Implications:
- Vacuum-assisted closure may be a viable option for managing severe episiotomy dehiscence.
- This therapy can potentially accelerate wound healing for complex postpartum perineal defects.
- Outpatient management of such cases may be facilitated by VAC therapy.
