Vacuum-Assisted Closure for Episiotomy Dehiscence.
BACKGROUND
Episiotomy dehiscence can result in a large vulvovaginal defect not amenable to delayed primary closure.


METHODS
A 26-year-old woman who underwent a forceps-assisted vaginal delivery with mediolateral episiotomy presented on postpartum day 5 with complete wound breakdown. Surgical exploration of the wound revealed a defect extending from the perineum into the vagina and deep into the ischiorectal fossa with poor tissue quality not amenable to a timely delayed primary closure. A vacuum-assisted closure device was used in lieu of traditional wound preparation and resulted in wound closure after 11 days of vacuum-assisted wound therapy.


CONCLUSIONS
A vacuum-assisted closure device may be appropriate in cases of complex episiotomy breakdown and may expedite wound healing in the outpatient setting.
Vincent Obstetrics and Gynecology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts.
Emeline M
EM
Aviki
Rebecca Posthuma
RP
Batalden
Marcela G
MG
Del Carmen
Lori R
LR
Berkowitz
D000328:Adult; D003646:Debridement / Q000379:methods; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods; D004841:Episiotomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D010502:Perineum / Q000601:surgery; D011247:Pregnancy; D018570:Risk Assessment; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology