Episiotomy is a cut in the perineum performed by the gynecologist or midwife during labor when conditions require it, to prevent vaginal tears and decrease the length of the expulsion period of the fetus. Once the baby is expelled, the edges of the incision are sutured to close the episiotomy.
Episiotomy dehiscence is when the edges of the incision separate due to suture failure; it can be classified as partial or complete dehiscence depending on the degree of wound opening.
It is usually caused by wound infection, although there are other causes that hinder proper healing of the suture: obesity, diabetes mellitus, poor nutrition, smoking, hematoma and/or inflammation of the scar.
Diagnosis is clinical by direct observation of the open wound, although it may be necessary to carry out an analysis to assess the existence of infection.
In most cases, it is decided to wait for the scar to close spontaneously, although it is a slow process that can last several weeks. When the tear is complete, it may be necessary to repair it with a second surgery. If there are signs of infection, antibiotic treatment will also be added.
- Kamel A, Khaled M. Episiotomy and obstetric perineal wound dehiscence: beyond soreness. J Obstet Gynaecol. 2014 Apr;34(3):215-7. doi: 10.3109/01443615.2013.866080. Epub 2014 Jan 31. PMID: 24484355.
- Uygur D, Yesildaglar N, Kis S, Sipahi T. Early repair of episiotomy dehiscence. Aust N Z J Obstet Gynaecol. 2004 Jun;44(3):244-6. doi: 10.1111/j.1479-828X.2004.00187.x. PMID: 15191450.
- Jones K, Webb S, Manresa M, Hodgetts-Morton V, Morris RK. The incidence of wound infection and dehiscence following childbirth-related perineal trauma: A systematic review of the evidence. Eur J Obstet Gynecol Reprod Biol. 2019 Sep;240:1-8. doi: 10.1016/j.ejogrb.2019.05.038. Epub 2019 Jun 1. PMID: 31202973.
