Episiotomy cut

Hi my wife had given a birth to our boy (still-birth) three weeks ago. She was given a episiotomy cut. She was re-adimitted after 3 days of discharge from hospital, with an infection in the womb and where the stitches were (the stiches have all come undone!). She was given 7 days of IV anitibiotics. Then dicharged with oral antibiotics at home..The docs recogn that the tear is quite deep and may have gone too close to the anal (rectal) area. We are still awaiting appointment to see a colorectal team.

The cut is wide open. the infection seems cleared, but the pain is still there. When she goes to toilet and wipes off properly, however when she washes in the shower few bits of stool wash away.

we are so confused as to what to do. She does have 2 baths everyday with tea-tree oil.

can you please advise. Thank you.

[Keith Downing, MD]

Hello,

My condolenses regarding the stillbirth.  You and your wife are carrying a heavy burden.

Sounds like your wife had a breakdown of her perineal tear and because it was infected they have delayed the closure.  There is very little literature on how best to deal with this.  In this situation some choose to wait until the tissue has recovered from the infection before repairing the defect (this may take weeks), while others perform the repair in the setting of infected tissue and treat the infection concurrently.  I don't think there is a right answer and there are likely to be differences between the gyn's and colo-rectal folks.  Talk with your ob/gyn and continue excellent peri-anal care until the visit with the colorectal docs.  

Best regards,

Dr. Downing