Factors associated with wound complications in women with obstetric anal sphincter injuries (OASIS)

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Abstract

Objective

We sought to determine factors associated with perineal wound complications in women with obstetric anal sphincter injuries (OASIS).

Study Design

A retrospective chart review of women who sustained an OASIS from Nov. 2, 2005, through March 1, 2010, was performed.

Results

In all, 1629 women sustained an OASIS; 909 had follow-up data. Wound complications (infection, breakdown, packing, operative intervention, secondary repair) occurred in 7.3% (n = 66) of patients. Smoking (odds ratio [OR], 4.04; 95% confidence interval [CI], 1.4–12.2; P = .01), increasing body mass index (OR, 1.06; 95% CI, 1.01–1.12; P = .04), fourth-degree laceration (OR, 1.89; 95% CI, 0.99–3.61; P = .05), operative vaginal delivery (OR, 1.76; 95% CI, 1.15–2.68; P = .009), and use of postpartum antibiotics (OR, 2.46; 95% CI, 1.11–5.63; P = .03) were associated with complications; intrapartum antibiotics were protective (OR, 0.29; 95% CI, 0.14–0.59; P = .001). In all, 44% of patients with a complication (n = 29) required hospital readmission; most (72%) were in the first 2 postpartum weeks.

Conclusion

Wound complications after OASIS are associated with modifiable factors and often require hospital readmission.

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