Question:medium
A woman delivered at home with a complete perineal tear and presents to the hospital 2 weeks later. What management will you prefer?
A woman delivered at home with a complete perineal tear and presents to the hospital 2 weeks later. What management will you prefer?
Show Hint
Past 24 hours the tissue is infected, so do not repair now; wait for healthy tissue.
Updated On: Jun 23, 2026
- Immediate repair
- Repair 3 weeks post-delivery
- Repair 6 weeks post-delivery
- Repair 3 months post-delivery
Show Solution
The Correct Option is D
Solution and Explanation
Timing rule: a complete perineal tear is repaired straight away only if it is fresh, within 24 hours of delivery. After that window the local tissue turns oedematous and infected, and any immediate stitch will simply give way.
This patient arrives at 2 weeks, well past 24 hours, so options 1, 2, and 3 (immediate, 3-week, and 6-week repair) are all too early because the area is still not surgically clean. You first control infection with antibiotics, let the wound granulate, and wait for the tissues to become supple and healthy again.
That maturation takes roughly 3 months, which is why definitive delayed repair of a neglected complete tear is scheduled at 3 months. Hence option 4. Ref: Dutta Obstetrics.
This patient arrives at 2 weeks, well past 24 hours, so options 1, 2, and 3 (immediate, 3-week, and 6-week repair) are all too early because the area is still not surgically clean. You first control infection with antibiotics, let the wound granulate, and wait for the tissues to become supple and healthy again.
That maturation takes roughly 3 months, which is why definitive delayed repair of a neglected complete tear is scheduled at 3 months. Hence option 4. Ref: Dutta Obstetrics.
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