https://kingstonhospital.nhs.uk/information/perineal-wound-breakdown
After you had your baby, your perineum may have been stitched to repair a tear or cut. The perineum is the area between your vagina and anus (back passage).
Occasionally these stiches come loose, leaving an opening or gap in your wound. This is called perineal wound breakdown. Usually this is due to an infection or pressure on the stitches caused by bleeding underneath the wound.
Symptoms of perineal wound breakdown include one or more of the following:
Your Community Midwife will check your stitches for signs of infection. If they suspect an infection, they may swab your wound and send the swab to the laboratory to check this and to find out if any specific bugs are causing an infection.
Most women with perineal wound breakdown will be given a short course of antibiotics by your GP or obstetrician and advised to take painkillers such as paracetamol. It may also help to take anti-inflammatory pain relief such as ibuprofen which is safe to take whilst breastfeeding your baby.
If the infection is making you unwell, you may be referred to hospital for a course of intravenous antibiotics (via a drip). After this treatment, we will offer you an appointment in the hospital’s Perineal Health Clinic for ongoing support until your wound has fully healed.
It is unlikely that we will re-stich your wound, especially if there is an infection, as this can trap the infection inside. Also, the infected tissue may not stitch back together well. Your midwife or GP will advise what is best for you.
Perineal wounds that have broken down usually heal well with time. During the healing process, new tissue gradually forms in the gap where the stitches were. The healing timeframe varies from person to person and depends on the extent of the wound.
Try to keep the wound as clean and dry as possible.
Shower rather than soaking in a bath. Avoid using shower gel or soap on the wound. Only apply water to the wound.
After washing, let the wound dry naturally, do not rub it with a towel.
Change your sanitary pad regularly (2 hourly).
In the privacy of your own home, try to leave your underwear off at night and let the wound ‘air dry’.
Avoid constipation by drinking plenty of water and maintaining a healthy balanced diet including fruit and vegetables.
Regular pelvic floor exercises help healing by increasing blood flow to the wound.
Download the NHS Squeezy app for guidance on how to do these exercises (see the link below).
Most women who experience a perineal wound breakdown have no further problems once the wound has healed. The wound will not break down again during exercise or sexual intercourse.
A perineal wound can ‘over heal’ leading to red patches of tissue called granulation tissue. Occasionally, this becomes uncomfortable and bleeds. It usually gets better with time and does not need treating.
However, if it does not improve or you are in significant discomfort, a perineal specialist midwife, consultant obstetrician or urogynecologist at the Perineal Health Clinic can treat it painlessly using silver nitrate. A midwife or doctor at the clinic will discuss whether this treatment is suitable for you.
If you experience a perineal wound breakdown once, it doesn’t mean you will experience this again with a future birth.
If you are worried about this during future pregnancies, tell your midwife or obstetrician and they can refer you to the Perineal Health Clinic. At the clinic, you can discuss your previous birth(s) and we will give you advice on ways to reduce the risk of perineal damage during childbirth.
 Royal College of Obstetricians and Gynaecologists: perineal tears www.rcog.org.uk/for-the-public/perineal-tears-and-episiotomies-in-childbirth |  |
 NHS Squeezy app to help with pelvic floor exercises www.squeezyapp.com |  |
| Perineal Specialist Midwife, Perineal Health Clinic (Willow Building), every Thursday 9.30 am to 5 pm |
020 8934 6174 khft.perinealhealth@nhs.net |
| Maternity Triage - for urgent concerns | 020 8934 2802 |
| Translate | Please speak to a member of staff before or during your visit to the hospital if you require translation. |
| Accessibility | Please contact the Patient Experience Team on 020 8934 3850 if you need this information in a different format. For information accessibility please visit Kingston Hospital AccessAble www.accessable.co.uk/kingston-hospital-nhs-foundation-trust |
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www.kingstonhospital.nhs.uk Switchboard 020 8546 7711 |
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Please speak to a member of staff before or during your visit to the hospital if you require translation support to access Patient Information. Please ring the phone number on your appointment letter, if you have one.
Please contact the Patient Experience Team on 020 893 3850 if you need this information in a different format.
For detailed information on accessibility at Kingston Hospital visit Kingston Hospital AccessAble (https://www.accessable.co.uk/kingston-hospital-nhs-foundation-trust).
Visit the hospital website, ask a member of staff, or ring us for details.