干旱区生态环境知识资源中心(Arid): Postpartum management of perineal injury-A critical narrative review of level 1 evidence

Arid

DOI	10.1016/j.midw.2022.103410
	Postpartum management of perineal injury-A critical narrative review of level 1 evidence
	White, Claire; Atchan, Marjorie
通讯作者	White, C
来源期刊	MIDWIFERY
ISSN	0266-6138
EISSN	1532-3099
出版年	2022
卷号	112
英文摘要	Perineal injuries are routinely classified into categories. These categories are further described in Fig. 1 . Rates of perineal injuries vary widely between countries. Eu-ropean data indicates rates of episiotomies range between (4.9% & minus;70%), first and second-degree tears (4% -58%) and third -and fourth-degree tears (0.1% & minus;4%) ( Blondel et al., 2016 ; Euro-Peristat, 2010 ). A systematic review of low-middle income coun-tries estimates an overall rate of 46% for episiotomies, 23% 2nd de-gree tear, and 1.4% OASIS injury ( Aguiar et al., 2019 ). Perineal trauma impacts upon the health and wellbeing of women in the short and long term. Impacts include perineal pain and discomfort, difficulty when mobilising, dyspareunia, and nerve pain. These morbidities correlate with developing postnatal de-pression, disruptions to maternal-infant bonding, and tocophobia ( Webb et al., 2014 ). Women who sustain severe (3rd and 4th) perineal tears are also at risk of urinary and flatus/faecal incon-tinence, as well as developing fistulas and pelvic organ prolapse ( Bagade and Mackenzie, 2010 ). Severe perineal tears are associated with significant adverse impacts on women socially and psycho-logically, with some women reporting social isolation, ongoing psy-chological trauma, and long-term negative effects on their sense of identity ( Priddis et al., 2014 ). Complications of the perineal wound healing process include infection, wound dehiscence, adhesions, and areas of excessive granulation tissue formation ( Webb et al., 2014 ). The process of perineal wound healing can also be affected by physiological and demographic factors, such as poor diet, obesity, smoking, disrup-tions to sleep, stress, tissue hypoxia, underlying medical condi-tions, and lack of access to adequate health care ( Dudley et al.,& nbsp;2013a ). A systematic review of the incidence of perineal wound infection and dehiscence concluded that the true rate of infec-tion remains unknown due to a lack of a core outcome set, lack of agreed definitions, and lack of a wound infection diagnostic tool ( Jones et al., 2019 ). Some women may avoid seeking as-sistance from health professionals due to feelings of shame or embarrassment in discussing their symptoms and vaginal health ( Wiseman et al., 2018 ). Prevention and early identification of prob-lems throughout the healing process can be aided by providing women with evidence-based treatment, information, and educa-tion regarding perineal wound healing. Clinical treatments should be based on the best available evi-dence. To assist in determining & lsquo;levels of evidence & rsquo;, the Oxford Cen-tre for Evidence Based Medicine (OCEBM) has developed the Levels of Evidence Table ( OCEBM Levels of Evidence Working Group, 2011 ). According to the OCEBM, the top level (level I) of evidence for de-termining treatment benefits and harms are systematic reviews of randomised trials or n-of-1 trials.
类型	Review
语种	英语
收录类别	SCI-E ; SSCI
WOS记录号	WOS:000841151300001
WOS关键词	TEARS ; TRAUMA
WOS类目	Nursing
WOS研究方向	Nursing
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/393799
推荐引用方式 GB/T 7714	White, Claire,Atchan, Marjorie. Postpartum management of perineal injury-A critical narrative review of level 1 evidence[J],2022,112.
APA	White, Claire,&Atchan, Marjorie.(2022).Postpartum management of perineal injury-A critical narrative review of level 1 evidence.MIDWIFERY,112.
MLA	White, Claire,et al."Postpartum management of perineal injury-A critical narrative review of level 1 evidence".MIDWIFERY 112(2022).