Obstet Gynecol Sci.  2019 May;62(3):186-189. 10.5468/ogs.2019.62.3.186.

Use of vacuum-assisted closure in massive puerperal genital hematoma

• Topdagi Yilmaz EP
• Yapca OE
• Cimilli Senocak GN
• Topdağı
• Al RA

• KMID: 2445078
• DOI: http://doi.org/10.5468/ogs.2019.62.3.186

Abstract

Puerperal genital hematomas are rare but life-threatening complications of obstetric emergencies. A pregnant patient (39 weeks) underwent a mediolateral episiotomy during a vaginal delivery. An afterbirth hematoma (approximately 20 cm in diameter) was evacuated, but the use of a vacuum-assisted wound closure system was applied after the sutures opened on the 7th postoperative day. On the 10th day of the vacuum-assisted closure (VAC) application, the wound was completely closed. VAC is an alternative treatment modality that can drain an infection and increase the proportion of granulation tissue in humid and irregular surfaces such as the perineum.

Keyword

Vaginal delivery; Vacuum-assisted closure; Perineal hematoma; Mediolateral episiotomy

MeSH Terms

Emergencies
Episiotomy
Female
Granulation Tissue
Hematoma*
Humans
Negative-Pressure Wound Therapy*
Perineum
Sutures
Wounds and Injuries

Figure

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  Fig. 1 (A) Episiotomy sutures about to rupture prior to hematoma drainage. (B) Wound dehiscence of episiotomy before vacuum-assisted closure.

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  Fig. 2 (A) Vaginally applied vacuum-assisted closure (VAC). (B) Open anal canal with VAC application. (C) Fully healed external genitalia.

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