Management of post-partum recurrent perineal wound dehiscence with flap cover

Abstract

Perineal wound dehiscence is a significant debilitating factor in the postpartum phase. Although the management of 3rd and 4th degree perineal tear is well described, there is no clear data about management of 2nd degree tear and wound dehiscence. Most are managed by secondary suturing or left to heal by secondary intention. Despite this many patients develop wound dehiscence and have long term complications due to scarring. In this case report we present a patient with recurrent wound dehiscence which was initially managed by multiple attempts at suturing. We did a debridement and lotus petal perforator flap to reconstruct the defect. Early use of flap cover in perineal wound dehiscence can achieve all the goals of wound management with good long term results.