Use of the Knutson's paste for the treatment of perineal wound dehiscence after vaginal delivery: a single-center clinical experience.

Background: The aim of this study was to retrospectively evaluate the therapeutic efficacy of the Knutson's paste, a solution composed of saccharose and povidone-iodine, in the management of perineal dehiscence following repair of post-partum laceration or episiotomy.

Methods: Thirty-seven women with post-partum perineal dehiscence were included in the study, conducted between September 2020 and December 2022. Patients self-applied the Knutson's paste three times per day for 14-21 days. Clinical evaluation was performed weekly; healing was defined as the closure of the wound margins. Recovery of sexual function was investigated with Female Sexual Function Index (FSFI) questionnaires at 6 months.

Results: All women achieved complete healing, and no one required resuturing. Full healing was achieved in 16.9±2.6 days. Second-degree dehiscence required significantly more days (24±2.64) to achieve healing compared to first-degree dehiscence (15.8±2.08). A mean of 3.4 outpatient visits was necessary during follow-up. The healing process and time were not associated with age, Body Mass Index (BMI), or birth weight. Around 50% of patients reported satisfying figures on FSFI questionnaires.

Conclusions: The Knutson's paste is a valid medicament for conservative treatment of post-partum perineal dehiscence. Due to its low costs and non-invasiveness, it could represent an alternative to the resuturing approach, especially in low-income countries and for women who refuse surgical revisions.