Factors associated with wound complications in women with obstetric anal sphincter injuries (OASIS)

Objective: We sought to determine factors associated with perineal wound complications in women with obstetric anal sphincter injuries (OASIS). Study Design: A retrospective chart review of women who sustained an OASIS from Nov. 2, 2005, through March 1, 2010, was performed. Results: In all, 1629 women sustained an OASIS; 909 had follow-up data. Wound complications (infection, breakdown, packing, operative intervention, secondary repair) occurred in 7.3% (n = 66) of patients. Smoking (odds ratio [OR], 4.04; 95% confidence interval [CI], 1.4-12.2; P =.01), increasing body mass index (OR, 1.06; 95% CI, 1.01-1.12; P =.04), fourth-degree laceration (OR, 1.89; 95% CI, 0.99-3.61; P =.05), operative vaginal delivery (OR, 1.76; 95% CI, 1.15-2.68; P =.009), and use of postpartum antibiotics (OR, 2.46; 95% CI, 1.11-5.63; P =.03) were associated with complications; intrapartum antibiotics were protective (OR, 0.29; 95% CI, 0.14-0.59; P =.001). In all, 44% of patients with a complication (n = 29) required hospital readmission; most (72%) were in the first 2 postpartum weeks. Conclusion: Wound complications after OASIS are associated with modifiable factors and often require hospital readmission.