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Varying Incidence and Definitions of Infection and Wound Dehiscence After Second-Degree Tear or Episiotomy: A
Kathrine Perslev1,2, Niels Klarskov3,4, Thomas Bergholt3,4
1Department of Obstetrics & Gynecology, Herlev University Hospital, Borgmester Ib Juuls Vej 1, 15, 2730, Herlev, Denmark. Kathrine.perslev@regionh.dk.
Introduction And Hypothesis:
Obstetric tears are a common complication of vaginal delivery, with second-degree tears and episiotomies being the most prevalent types. Despite their prevalence, the incidence of healing complications are not clearly defined. This review aims to consolidate the current knowledge.
Methods:
This systematic review examines the risk of wound dehiscence and infection following second-degree tears and episiotomies. Literature searches were conducted across three databases: PubMed, Embase, and Cochrane. Two authors independently and blindly selected studies deemed relevant based on their title and abstract. Full-text screening was then performed, and included studies were assessed for risk of bias.
Results:
The review included 15 papers and found that the risk of infection ranged from 0 to 30%, and wound dehiscence from 0 to 22%. However, the review revealed substantial variation in definitions, evaluation methods, assessment timing, and preventive treatments. Studies incorporating clinical evaluations 1-3 weeks postpartum reported a higher prevalence of complications (infection 5.3%, dehiscence 9.3%) compared to those without such assessments (infection 1.8%, dehiscence 3.6%).
Conclusions:
Second-degree tears and episiotomies are common, with up to 30% experiencing healing complications. This review found higher rates in studies with clinical follow-up 1-3 weeks postpartum, though precise estimates are limited by varying follow-up times and outcome definitions. This underscores the need for further research and increased clinical focus on these complications.
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