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Treatment of perineal wounds during the post partum period: evaluation of whether or not antibiotic should be systematically prescribed.

Abstract Genital tract integrity is not always mantained during childbirth. No treatment protocol for post-partum perineal wounds (tears and episiotomies) existed in our Department, thus their management depends upon clinician. This study aimed to establish the role of antibiotic in the treatment of post-partum perineal wounds as well as the impact of antibioprophylaxis on wound healing and on prevention of infectious complications after repair.
PMID
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Authors

Mayor MeshTerms
Keywords

Effectiveness

antibiotic

episiotomy

perineal wounds

tears

treatment

Journal Title the pan african medical journal
Publication Year Start




PMID- 29564033
OWN - NLM
STAT- MEDLINE
DCOM- 20180405
LR  - 20180405
IS  - 1937-8688 (Electronic)
VI  - 28
DP  - 2017
TI  - [Treatment of perineal wounds during the post partum period: evaluation of
      whether or not antibiotic should be systematically prescribed].
PG  - 144
LID - 10.11604/pamj.2017.28.144.12915 [doi]
AB  - Introduction: Genital tract integrity is not always mantained during childbirth. 
      No treatment protocol for post-partum perineal wounds (tears and episiotomies)
      existed in our Department, thus their management depends upon clinician. This
      study aimed to establish the role of antibiotic in the treatment of post-partum
      perineal wounds as well as the impact of antibioprophylaxis on wound healing and 
      on prevention of infectious complications after repair. Methods: We conducted a
      prospective cohort study in the Department of Gynecology and Obstetrics at the
      Central Hospital of Yaounde over a period of 6 months, from 1 January to 31 May
      2016. Post-partum women with perineal tear and/or episiotomy were divided into
      two groups (A and B) and followed up. The group A was composed by 85 post-partum 
      women under treatment protocol based on compresses soaked in Betadine((R))
      (placebo). The Group B (or test group) was composed of post-partum women who had 
      received placebo plus antibiotic (oral amoxicillin/clavulanic acid 875 mg/125 mg 
      twice a day for 05 days). Both groups were followed up on day 0, day 2 and day 9.
      Our criteria for the evaluation of treatment were: pain, infection, swelling,
      cleanliness of the wounds and average healing time. Data were collected and
      analyzed using the software Epidata analysis version 3.2 and STATA version 12.0
      (Texas USA 2001). The correlations between the variables were identified by
      chi-square, odds ratio and p value (using any p-value </= 0.05 as statistical
      significance cut-off) according to the case. Results: The average age was 26.32
      +/- 6.5 years, ranging between 15 and 43 years. Primiparous women accouted for
      55.9% of the study population. At day 0 post-partum the main symptom was pain,
      without significant predominance of a group (OR = 0.9; CI = 0.14-7.19; p = 1).
      Swollen wounds were the second complaint, without significant variation between
      the two groups (OR = 1.69; CI = 0.88-3.24; p = 0.13). At day 0, day 2 and day 9
      no significant variation was observed between the two treatment protocols with
      regard to the indicators analyzed: pain evolution, infection, swelling and
      average healing time. At day 9 the healing was complete in both groups and the
      two treatment protocols were shown to be equivalent in their effectiveness and
      prevention of infections. Conclusion: At the end of this study the two treatment 
      protocols were shown to be equivalent. Antibiotics should not be prescribed for
      perineal wounds in order to contain the healthcare costs.
FAU - Fouelifack, Florent Ymele
AU  - Fouelifack FY
AD  - Departement de Gynecologie et Obstetriques de l'Institut Superieur de Technologie
      Medicale de Nkolondom a Yaounde, Unite de Gynecologie et Obstetriques de
      l'Hopital Central de Yaounde, Cameroun.
FAU - Eko, Filbert Eko
AU  - Eko FE
AD  - Departement de Gynecologie et Obstetriques de l'Institut Superieur de Technologie
      Medicale de Nkolondom a Yaounde, Unite de Gynecologie et Obstetriques de
      l'Hopital Central de Yaounde, Cameroun.
FAU - Ko'A, Claude Odile Vanessa Ebode
AU  - Ko'A COVE
AD  - Institut Superieur de Technologie Medicale de Nkolondom a Yaounde, Faculte de
      Medecine et des Sciences Biomedicales de l'Universite de Yaounde I, Cameroun.
FAU - Fouedjio, Jeanne Hortence
AU  - Fouedjio JH
AD  - Departement de Gynecologie et Obstetriques de la Faculte de Medecine et des
      Sciences Biomedicales de l'Universite de Yaounde I, Unite de Gynecologie et
      d'Obstetrique de l'Hopital Central de Yaounde, Cameroun.
FAU - Mbu, Robinson Enow
AU  - Mbu RE
AD  - Departement de Gynecologie et Obstetriques de la Faculte de Medecine et des
      Sciences Biomedicales de l'Universite de Yaounde I, Unite de Gynecologie et
      d'Obstetrique de l'Hopital Central de Yaounde, Cameroun.
LA  - fre
PT  - Comparative Study
PT  - Journal Article
TT  - Prise en charge des plaies du perinee en post partum: faut-il prescrire
      systematiquement un antibiotique?
DEP - 20171016
PL  - Uganda
TA  - Pan Afr Med J
JT  - The Pan African medical journal
JID - 101517926
RN  - 0 (Anti-Bacterial Agents)
RN  - 74469-00-4 (Amoxicillin-Potassium Clavulanate Combination)
RN  - 85H0HZU99M (Povidone-Iodine)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Amoxicillin-Potassium Clavulanate Combination/administration & dosage
MH  - Anti-Bacterial Agents/*administration & dosage
MH  - Cameroon
MH  - Cohort Studies
MH  - Delivery, Obstetric
MH  - Episiotomy/*adverse effects/methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Infection/epidemiology
MH  - Lacerations/*drug therapy
MH  - Pain/epidemiology
MH  - Perineum/injuries
MH  - Postpartum Period
MH  - Povidone-Iodine/administration & dosage
MH  - Pregnancy
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Wound Healing/*drug effects
MH  - Young Adult
PMC - PMC5851669
OTO - NOTNLM
OT  - Effectiveness
OT  - antibiotic
OT  - episiotomy
OT  - perineal wounds
OT  - tears
OT  - treatment
EDAT- 2018/03/23 06:00
MHDA- 2018/04/06 06:00
CRDT- 2018/03/23 06:00
PHST- 2017/05/30 00:00 [received]
PHST- 2017/09/23 00:00 [accepted]
PHST- 2018/03/23 06:00 [entrez]
PHST- 2018/03/23 06:00 [pubmed]
PHST- 2018/04/06 06:00 [medline]
AID - 10.11604/pamj.2017.28.144.12915 [doi]
AID - PAMJ-28-144 [pii]
PST - epublish
SO  - Pan Afr Med J. 2017 Oct 16;28:144. doi: 10.11604/pamj.2017.28.144.12915.
      eCollection 2017.