The effect of perineal wound infection on the anal sphincter
Research type
Research Study
Full title
A prospective observational study evaluating the sonographic appearance of the anal sphincter in women with perineal wound infection following vaginal delivery.
IRAS ID
278466
Contact name
Abdul H. Sultan
Contact email
Sponsor organisation
Croydon Health Services
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Approximately 85% of women sustain perineal injury following a vaginal delivery. Injury is either spontaneous, following episiotomy(surgical incision) or a combination of the two, with 69% of wounds needing repair by suturing. In 6 percent of women undergoing their first vaginal delivery injury can extend into the anal sphincter(Obstetric Anal Sphincter Injury [OASI]).
Perineal injury following childbirth can lead to complications such as wound infection and dehiscence which can cause a prolonged postnatal recovery period. At Croydon University Hospital, between January 2016-September 2017 the incidence of perineal wound infection following a vaginal delivery was 22.6%
Croydon Health Services has a dedicated perineal service which reviews women with perineal wound complications following childbirth. In addition, as endoanal ultrasound(where an ultrasound probe is inserted directly into the anal canal) is the gold standard diagnostic tool used to detect OASI, in these women, ultrasound is also completed in clinic. As structures within the perineum lie very close to the anal canal, it is possible that in the case of perineal injury with an intact anal sphincter, as wound infection progresses and affects deeper structures the anal sphincter may then be affected. Ultrasound has never been used to evaluate the progression of infection and the integrity of the anal sphincter in perineal wound infection.
The purpose of this study is to determine if perineal wound infection can extend to involve the anal sphincter and lead to its disruption following repair of childbirth related perineal injury including OASI.
REC name
London - Surrey Research Ethics Committee
REC reference
20/LO/0304
Date of REC Opinion
31 Mar 2020
REC opinion
Favourable Opinion