E-Posters-10177

10177_Giugale
Pdf Summary
The study evaluated the use of prophylactic antibiotics for the repair of obstetric anal sphincter injuries (OASIS) in a large cohort of patients. The study found that only 12% of patients received prophylactic antibiotics at the time of OASIS repair. The strongest predictor for antibiotic use was performing the repair in the operating room.<br /><br />The study also assessed postpartum wound complications in women with 4th degree tears. It found that 31% of these women presented with perineal concerns in the postpartum period. However, the assessment of wound complications was limited by missing data and may have been underpowered to assess predictors of wound complications.<br /><br />Based on level 1 evidence and the 2016 ACOG Practice Bulletin, the study recommends prophylactic antibiotic administration for the repair of 3rd and 4th degree OASIS to reduce the rate of wound infection and breakdown. However, the study raises the question of whether healthcare providers are adhering to this recommendation.<br /><br />The study included 2,312 cases of OASIS out of 91,387 deliveries. After excluding patients with group B streptococcus and chorioamnionitis, 12% of cases were 4th degree tears and 87.6% were 3rd degree tears. Only 8.8% of OASIS repairs were performed in the operating room. Overall, only 12% of patients received prophylactic antibiotics at the time of OASIS repair.<br /><br />The study found no significant predictors of wound complications in the cohort of patients with 4th degree tears. However, only 51.2% of these patients had postpartum follow-up data, which may have limited the assessment.<br /><br />In conclusion, the study suggests that antibiotic administration rates for OASIS repair are below the recommended guidelines. It emphasizes the need for a specialty-wide change in practice patterns to adhere to recent ACOG recommendations. The study also highlights the importance of postpartum follow-up to fully assess wound complications in patients with 4th degree tears.
Keywords
prophylactic antibiotics
repair
obstetric anal sphincter injuries
OASIS
patients
operating room
postpartum wound complications
4th degree tears
wound infection
ACOG Practice Bulletin