FACTORS INFLUENCING THE PROCESS OF PERINEAL WOUND HEALING IN POSTPARTUM WOMEN IN SERUI HOSPITAL, PAPUA

Background: The process of giving birth has a risk of perineal rupture. The 4.9% incidence of delayed perineal wound healing resulted from non-fused perineal wounds and clinical infection. This process can be interrupted or recovery delayed due to various factors such as age, nutrition, pain, and poor hygiene. This study aims to analyze the factors that influence the healing process of perineal wounds in postpartum mothers. Method: analytic observational research method with cross sectional approach and analityc statistic Chi-Square. The samples are postpartum woman in Serui Hospital, Papua. The number of samples were 30 respondents with purposive sampling technique. The instrument used was the REEDA scale, the pain scale, the food consumption survey with the 24-hour recall method and the personal hygiene questionnaire. Results: The results of statistical tests showed a relationship between pain with the perineal wound healing process is p 0,017, age with the perineal wound healing process is p 0,000, nutrition with the perineal wound healing process is p 0,000, and personal hygiene pain with the perineal wound

The Effect of Betel Leaf Water Decoction on Perineal Wound Healing among Post Partum Women

The prevalence of maternity women with perineal injuries in Indonesia in the 25-30 year age group waa 24%, while the 32-39 year old was 62%. Perineal wounds are the cause of postpartum maternal bleeding. Postpartum causes are the main cause of 40% of maternal deaths in Indonesia. This study aimed to determine the effect of betel leaf water decoction on post partum women perineal wound healing at the Independent Practice of midwife R. Agustina in West Bandung in 2021. This research used the Quasi Experimental Design method, with the Post Only Control Group approach. The population in this study were all postpartum women who had grade I and II perineal injuries at PMB R. Agustina in July 2021 which consisted of 30 respondents. The location of this research was carried out at the Independent Practice of the midwife R. Agustina West Bandung in July 2021. The variables of this study were betel leaf boiled water and perineal wounds. The research instrument was the REEDA Scale. The results showed that the average perineal wound healing before intervention in the experimental group was 10.60 and after intervention was 5.87, while the average perineal wound healing before test was 10.87 and after the test was 6.93. There were differences in perineal wound healing between the experimental and control groups at PMB R. Agustina West Bandung (p-value = 0.012). This intervention is expected to be used by the community as a method in overcoming the problem of perineal wound healing among post partum women.

Differences in Counseling Using Leaflets with Videos On Perineal Wound Treatment

Background: Perineal wound needs to be treated to prevent infection, so postpartum needs counseling about perineal wound care. The perineal wound healing can be identified if the wound is dry, skin has been fused, not palpable and painless. This research aims to determine the different of counseling using leaflet with video toward perineal wound care behavior in primipara postpartumMethods: Quasi experiment with pre test and post test control group design. Pre test was conducted on the first day of the post partum, post test on the 7th day when the respondent controls the perineum wound. Instrument in this research used questionnaire regarding the behavior of perineal wound care. Samples in the research of a number of 30 people were taken in purposive sampling. Data analysis used the independent T test.Results: There were significant difference in counseling using leaflets and videos about the behavior of perineum wound care. The group that received perineal wound care counseling using video was better (p=0.015) than the leaflet group (p=0.034).Conclusions: Counseling about perineal wound care used videos more effective than leaflets.

Determinan terhadap Penyembuhan Luka Perineum pada Ibu Nifas di Praktik Mandiri Bidan Kota Palangkaraya

Maternal mortality in Indonesia related to childbirth is 11% infection starting from poor management of perineal rupture. Approximately 85% of women who deliver vaginally have perineal trauma, and less than 1% of episiotomy or perineal ruptures have an infection. The general objective of this study was to analyze the factors that influence the healing of perineal wounds in postpartum women. This research is an analytic observational with a cross-sectional design. The sampling technique used is purposive sampling. The sample of this study was postpartum women who experienced a second-degree perineal rupture in PMB in the Palangka Raya City. The results of the Chi-Square test analysis showed a significant relationship between education (p-value = 0.010), nutritional status (p-value = 0.001), and hemoglobin levels (0.000) with the duration of perineal wound healing. There is a relationship between education, nutritional status, and hemoglobin levels on perineal wound healing.

A comparative multicentre study evaluating gluteal turnover flap for wound closure after abdominoperineal resection for rectal cancer

Background The aim of this study was to compare perineal wound healing between gluteal turnover flap and primary closure in patients undergoing abdominoperineal resection (APR) for rectal cancer. Methods Patients who underwent APR for primary or recurrent rectal cancer with gluteal turnover flap in two university hospitals (2016–2021) were compared to a multicentre cohort of primary closure (2000–2017). The primary endpoint was uncomplicated perineal wound healing within 30 days. Secondary endpoints were long-term wound healing, related re-interventions, and perineal herniation. The perineal hernia rate was assessed using Kaplan Meier analysis. Results Twenty–five patients had a gluteal turnover flap and 194 had primary closure. The uncomplicated perineal wound-healing rate within 30 days was 68% (17/25) after gluteal turnover flap versus 64% (124/194) after primary closure, OR 2.246; 95% CI 0.734–6.876; p = 0.156 in multivariable analysis. No major wound complications requiring surgical re-intervention occurred after flap closure. Eighteen patients with gluteal turnover flap completed 12-month follow-up, and none of them had chronic perineal sinus, compared to 6% (11/173) after primary closure (p = 0.604). The symptomatic 18-month perineal hernia rate after flap closure was 0%, compared to 9% after primary closure (p = 0.184). Conclusions The uncomplicated perineal wound-healing rate after the gluteal turnover flap and primary closure after APR is similar, and no chronic perineal sinus or perineal hernia occurred after flap closure. Future studies have to confirm potential benefits of the gluteal turnover flap.

Metastasierender Morbus Crohn vielleicht häufiger als bisher angenommen

<b>Background:</b> Metastatic Crohn’s disease (CD) is a rare manifestation of CD. It involves inflammatory skin lesions with histopathological findings (granulomas) similar to CD, without connection to the gastrointestinal tract. Hyperbaric oxygen therapy (HBO) has been suggested as a possible treatment option. <b>Objective:</b> This study aimed to identify and treat a consecutive series of patients with biopsy-proven metastatic CD and monitor wound healing using prospectively acquired outcomes. <b>Methods:</b> Pathology results of all patients with ongoing perineal wound-healing problems after proctectomy between 2005 and 2018 at the Amsterdam University Medical Centre were assessed for metastatic CD. Patients with a biopsy-proven diagnosis of perineal metastatic CD were offered HBO (40 daily sessions of 100% oxygen at 2.4 atmosphere absolute). Wound healing was monitored using photographs and standardised questionnaires (the Inflammatory Bowel Disease Questionnaire, EuroQol Visual Analogue Scale and the Female Sexual Function Index) at baseline and 1 and 3 months after HBO. <b>Results:</b> Out of 13 patients in the cohort with persisting perineal wounds after proctectomy, six (46%) had biopsy results consistent with metastatic CD. Of these, three accepted treatment with HBO. All three patients were female. One patient had complete healing of her perineal wound; another patient showed initial improvement but had a flare of luminal and perineal disease at the 3-month follow-up. The third patient showed improvement solely in the questionnaires, with higher scores on all three questionnaires. <b>Conclusion:</b> A high rate of metastatic CD was found in patients with ongoing wound-healing problems after proctectomy, implying that the disease might not be as rare in these selected patients as previously thought. HBO might be beneficial in the treatment of metastatic CD.

Factor Affecting Perineal Wound Healing

Perineal wound cause many problems, likea as many as 70% of postpartum mothers have difficulty defecating, 60% of postpartum mothers have difficulty with mictie, 30% of postpartum mothers complain of UTI signs, 60% of breast milk is substandard so that formula milk is added and 10% of mothers with subinvolution uteri. Perineal wound can heal immediately if the postpartum mother has a good hemoglobin level, to get enough hemoglobin, one of them is by consuming Fe tablets and vitamin C. It was found that as many as 60% of postpartum women with perineal wound healing 8 to 14 days. The goals of this research is to find factors that affecting perineal wound healing.This type of research is correlational analytic with cross sectional time approach. The population is postpartum mothers in the working area of Kedu Public Health Center, Temanggung Regency, from September to November 2018. The samples were obtained using quota sampling sampling with 40 postpartum mothers. Spearman rank test showed results of haemoglobin level and perineal wound care related to the speed of healing of perineal wounds (pvalue of hb level 0.00 and pvalue perineal wound care 0.027), multivariat test using linear regression where there is influence of hemoglobin level and perineal care to the speed of perineal wound healing (pvalue 0,021).Midwives are expected to screen haemoglobin levels and monitor perineal wound care performed by the mother to prevent delays in healing perineal wounds Keywords: BMI, age, hemoglobin level, perineal care,perineal wound healing

Retrospective observational study to evaluate the concept of the warm versus regular room temperature seitz bath in perineal wound healing

Background: Seitz bath in post-perineal surgery minimizes pain by reducing anal sphincter tone and also maintains hygiene. The aim and objective of this retrospective study is to compare the effect of warm versus regular room temperature seitz bath. The article clears the concept of seitz bath. The seitz bath gives psychological satisfaction of dressing to patient and helps in boosting the concept of hygiene in their mind.Method: Study design for this study was comparative study of warm and room temperature seitz bath on 60 patients by convenience sampling operated for perineal diseases from 01 November 2019 to 30 March 2020 with written informed consent of patient and fulfilling ethical requirements at Rajiv Gandhi Medical College, Thane, Mumbai. Patients with immunocompromised status and comorbidities like diabetes, tuberculosis, HIV were excluded from study this was the criteria for the study.Results: Out of 60 postoperative cases having perineal wounds, 35 (58.33%) patients opted for warm water seitz bath, while the rest 25 (41.66%) preferred regular room temperature seitz bath. In spite of a greater number of patients opting for warm seitz bath, wound recovery in terms of healing and wound discharge was almost similar in both the study groups. All the patients involved in the study were comfortable to resume their daily activities with significant reduction in pain by the end of first week irrespective of the choice of seitz bath they opted for.Conclusion: The study concludes that symptomatic relief and wound recovery in the operated cases of perineal surgeries completely independent of the choice of seitz bath practiced.