干旱区生态环境知识资源中心(Arid): Postpartum perineal wound infection and its effect on anal sphincter integrity. Results of a prospective observational study

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DOI	10.1111/aogs.14515
	Postpartum perineal wound infection and its effect on anal sphincter integrity. Results of a prospective observational study
	Okeahialam, Nicola Adanna; Thakar, Ranee; Sultan, Abdul H.
通讯作者	Sultan, AH
来源期刊	ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
ISSN	0001-6349
EISSN	1600-0412
出版年	2023
卷号	102 期号:4 页码:473-479
英文摘要	Introduction: Perineal wound infection can affect tissues at superficial, deep, and organ space levels. Women with obstetric anal sphincter injuries (OASIS) are at risk of infection; however, no study to date has investigated if infection can extend to affect the anal sphincter integrity. The aim of this study was to evaluate the clinical progression of perineal wound infection and its effect on the anal sphincter in women with or without OASIS using three-dimensional endoanal ultrasound (3D-EAUS). Material and methods: Women were recruited into the Prospective Observational Study Evaluating the Sonographic Appearance of the Anal Sphincter in Women With Perineal Wound Infection Following Vaginal Delivery (PERINEAL Study) between August 2020 and August 2021 (NCT 04480684). 3D-EAUS was performed weekly until complete wound healing. Significant bacterial colonization was diagnosed using the MolecuLight i:X camera. The primary study outcome was a change in a sphincter defect angle from baseline (wound infection) until wound healing. A robust Poisson regression model was used to analyze the effect of significant bacterial loads on the anal sphincter. Results: Seventy-three women were included. A median of two ultrasound scans were performed in each patient (range 1-16). Five women (6.8%) had an OASI clinically diagnosed at delivery. In total, 250 EAUS were performed. An external anal sphincter defect was found on EAUS in 55 (22.0%) scans (n = 10 women). An external anal sphincter and internal anal sphincter defect was found in 26 scans (10.4%) (n = 3 women). During the course of the wound healing process, there was no significant change in defect size in wounds with or without significant bacterial colonization. In cases of an intact anal sphincter, wound infection did not disrupt its integrity. Conclusions: We found that perineal wound infection does not disrupt an intact anal sphincter or OASIS. This new information can provide important information for clinicians and patients. As there are myths frequently encountered in cases of litigation when disruption of sphincter integrity is attributed to perineal infection, the findings of this study should be tested in larger studies in the future.
英文关键词	bacterial autofluorescence endoanal ultrasound obstetric anal sphincter injury perineal wound infection severe perineal laceration third-degree tears transperineal ultrasound
类型	Article
语种	英语
开放获取类型	Green Published, Green Accepted, hybrid
收录类别	SCI-E
WOS记录号	WOS:000918934300001
WOS关键词	PREDICTS
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/394961
推荐引用方式 GB/T 7714	Okeahialam, Nicola Adanna,Thakar, Ranee,Sultan, Abdul H.. Postpartum perineal wound infection and its effect on anal sphincter integrity. Results of a prospective observational study[J],2023,102(4):473-479.
APA	Okeahialam, Nicola Adanna,Thakar, Ranee,&Sultan, Abdul H..(2023).Postpartum perineal wound infection and its effect on anal sphincter integrity. Results of a prospective observational study.ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA,102(4),473-479.
MLA	Okeahialam, Nicola Adanna,et al."Postpartum perineal wound infection and its effect on anal sphincter integrity. Results of a prospective observational study".ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 102.4(2023):473-479.