ORIGINAL ARTICLE   

Minerva Obstetrics and Gynecology 2024 Nov 27

DOI: 10.23736/S2724-606X.24.05588-X

Copyright © 2024 EDIZIONI MINERVA MEDICA

lingua: Inglese

Use of the Knutson’s paste for the treatment of perineal wound dehiscence after vaginal delivery: a single-center clinical experience

Ottavio CASSARDO ¹ ✉, Francesca GIGLI ¹, Giuseppe PERUGINO ¹, Enrico FERRAZZI ^{1, 2}, Ilma F. CARBONE ¹, Gabriele ROSSI ¹, Carmela COPPOLA ¹

¹ Unit of Obstetrics, Department of Woman, Child and Neonate, Mangiagalli Center, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; ² Department of Clinical and Community Sciences, University of Milan, Milan, Italy

BACKGROUND: The aim of this study was to retrospectively evaluate the therapeutic efficacy of the Knutson’s paste, a solution composed of saccharose and povidone-iodine, in the management of perineal dehiscence following repair of post-partum laceration or episiotomy.
METHODS: Thirty-seven women with post-partum perineal dehiscence were included in the study, conducted between September 2020 and December 2022. Patients self-applied the Knutson’s paste three times per day for 14-21 days. Clinical evaluation was performed weekly; healing was defined as the closure of the wound margins. Recovery of sexual function was investigated with Female Sexual Function Index (FSFI) questionnaires at 6 months.
RESULTS: All women achieved complete healing, and no one required resuturing. Full healing was achieved in 16.9±2.6 days. Second-degree dehiscence required significantly more days (24±2.64) to achieve healing compared to first-degree dehiscence (15.8±2.08). A mean of 3.4 outpatient visits was necessary during follow-up. The healing process and time were not associated with age, Body Mass Index (BMI), or birth weight. Around 50% of patients reported satisfying figures on FSFI questionnaires.
CONCLUSIONS: The Knutson’s paste is a valid medicament for conservative treatment of post-partum perineal dehiscence. Due to its low costs and non-invasiveness, it could represent an alternative to the resuturing approach, especially in low-income countries and for women who refuse surgical revisions.

KEY WORDS: Povidone-iodine; Episiotomy; Lacerations; Postpartum period