Incidence of complete vaginal cuff wound healing at sixth and eighth week after total abdominal hysterectomy

Watcharaprapapong, Jiraphan; Treetampinich, Chatchai; Ayudhya, Nathpong Israngura Na; Paiwattananupant, Krissada; Chinthakanan, Orawee

doi:10.1111/jog.13829

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…Finally, standard care follow-up after hysterectomy involves assessment six weeks after surgery, 28 but recent analysis has proposed it may take longer before vaginal cuff healing is complete in most cases. 29 The healing rates at 6 weeks in this study were consistent with full healing taking longer than six weeks. Thus, following the animals out beyond 6 weeks may have provided additional healing information.…”

Section: Discussionsupporting

confidence: 79%

Development of a Chronic Canine Ovariohysterectomy Model to Evaluate Vaginal Cuff Healing Using Two Closure Systems

et al. 2021

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Background and Purpose. This study established a suitable animal model of ovariohysterectomy; characterized the course and pattern of vaginal healing after ovariohysterectomy; and compared healing obtained after closure of the vaginal cuff with a novel cuff-closure device (Zip-stitch® clips) and VICRYL® sutures. Research Design and Study Sample. This prospective, randomized, controlled, blinded animal study was conducted in 27 mongrel hounds according to an IACUC-approved protocol. Each animal underwent ovariohysterectomy followed by vaginal cuff closure with Zip-stitch or VICRYL. At two or six weeks, animals were sacrificed for gross and histological analysis. Data Collection. The primary endpoint was the difference in the fraction of vaginal cuff healed six weeks after application of the closure device. Secondary endpoints included histopathologic cellular and tissue responses, including inflammation, necrosis, infection, and vascular and muscle changes. Results. In the test group, there were two distinct locations where fibrotic or granular tissue fusion between the anterior and posterior vaginal walls was observed: in tissue “captured” by a clip or in tissue around the clip. The fraction of the vaginal cuff healed was similar in animals treated with Zip-stitch clips and those treated with sutures at six weeks (68±10% vs 67±18%; P=.148, test for non-inferiority) after surgery. The test article performed similarly or better than the control article in terms of the intensity or extent of the secondary endpoints. Conclusions. Subject to further confirmation, this study supports Zip-stitch clips as a method to maintain immediate post-operative approximation of the vaginal cuff leading to healing but did not achieve statistical significance in its primary endpoint.

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Section: Discussionsupporting

confidence: 79%

Development of a Chronic Canine Ovariohysterectomy Model to Evaluate Vaginal Cuff Healing Using Two Closure Systems

et al. 2021

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Utility of Routine Postoperative Examination for Detecting Vaginal Cuff Dehiscence After Total Laparoscopic Hysterectomy

Caskey,

Niino,

Meyer

et al. 2024

Journal of Minimally Invasive Gynecology

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Presentation and Management of Postpartum Granulation Tissue: A Single‐Institution Retrospective Study

Kette,

Kumnick,

Budd

et al. 2024

J Midwife Womens Health

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IntroductionAlthough the development of postpartum granulation tissue (PPGT) is an expected phase of healing of perineal and vaginal lacerations, the persistence of this tissue can result in delayed wound healing, pain, bleeding, and discharge. There is a paucity of information on the efficacy of the treatments used for pathologic PPGT. The objective of this study was to describe characteristics associated with the development of PPGT and the treatment methods currently used for management.MethodsThis was a retrospective cohort study of 140 patients diagnosed with PPGT within one year of birth from 2012 through 2022 within a single health care system. Patients were identified by International Classification of Diseases and Current Procedural Terminology codes. Demographics, birth characteristics, symptoms, and treatment information were obtained and assessed in frequencies and means. Treatments were compared with 95% CIs and P values. Time to resolution was assessed by the number of weeks and the number of visits.ResultsIt was the first vaginal birth for 129 (92%) patients in the study cohort. The majority (84.3%) of patients presented with pain. Almost half of all patients (45%) were diagnosed after 6 weeks postpartum. 30.0% of patients were initially treated conservatively. 76.4% of patients were treated with silver nitrate, and 33.6% had an excisional procedure. Successful conservative management had the lowest average number of visits to resolution with 1.39 visits (95% CI, 1.15‐1.69), followed by silver nitrate alone with 1.95 visits (95% CI, 1.73‐2.19), and excision with or without silver nitrate with 2.40 visits (95% CI, 2.07‐2.78). Conservative management was unsuccessful 45% of the time, requiring additional treatment with silver nitrate or excision. 30% of patients treated with silver nitrate or excision continued to report pain even after the resolution of granulation tissue upon examination.ConclusionPPGT is commonly associated with first vaginal births, often presents beyond 6 weeks postpartum, and frequently requires treatment.

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Incidence of complete vaginal cuff wound healing at sixth and eighth week after total abdominal hysterectomy

Cited by 3 publications

References 6 publications

Development of a Chronic Canine Ovariohysterectomy Model to Evaluate Vaginal Cuff Healing Using Two Closure Systems

Development of a Chronic Canine Ovariohysterectomy Model to Evaluate Vaginal Cuff Healing Using Two Closure Systems

Utility of Routine Postoperative Examination for Detecting Vaginal Cuff Dehiscence After Total Laparoscopic Hysterectomy

Presentation and Management of Postpartum Granulation Tissue: A Single‐Institution Retrospective Study

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