Evidence map›Paper›PMID 36707852›Full record

Observational studyActa obstetricia et gynecologica Scandinavica2023

Postpartum perineal wound infection and its effect on anal sphincter integrity: Results of a prospective observational study.

Nicola Adanna Okeahialam, Ranee Thakar, Abdul H Sultan

Registry-linked trialOpen access · diamondAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Acta obstetricia et gynecologica Scandinavica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04480684 (A Prospective Observational Study Evaluating the Sonographic Appearance of the Anal Sphincter in Women With Perineal Wound Infection Following Vaginal Delivery.), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04480684 completednot on this map

A Prospective Observational Study Evaluating the Sonographic Appearance of the Anal Sphincter in Women With Perineal Wound Infection Following Vaginal Delivery.

TypeobservationalSponsorCroydon Health Services NHS TrustRan2020 to 2021Enrolled80ConditionsObstetric Trauma, Perineum, Injury, Perineal InfectionArmsThree-dimensional Endoanal Ultrasound, Transperineal Ultrasound(multiplanar), The MolecuLight i:X: Bacterial autofluorescence camera, Silhouette® 3D camera: Three-dimensional wound measuring camera
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Review
  3. Review
  4. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Nicola Adanna OkeahialamCroydon University Hospital, Croydon, UK.
Ranee ThakarCroydon University Hospital, Croydon, UK.
Abdul H SultanCroydon University Hospital, Croydon, UK.ORCID 0000-0001-8979-2304
St George's, University of London · GBCroydon University Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPerineal 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

methodsWomen 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 (NCT04480684). 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.

resultsSeventy-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.

conclusionsWe 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.

Indexed as

Fecal IncontinenceLacerationsObstetric Labor ComplicationsPuerperal InfectionAnal CanalDelivery, ObstetricFemaleHumansPerineumPostpartum PeriodPregnancyProspective StudiesUltrasonographybacterial autofluorescenceendoanal ultrasoundobstetric anal sphincter injuryperineal wound infectionsevere perineal lacerationthird-degree tearstransperineal ultrasound

Identifiers

PMID36707852
PMCPMC10008287
OpenAlexW4318391889

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.