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8. For repair of a full thickness EAS tear, either an overlapping or an end-to-end method

using 3-0 polydioxanone or 2-0 polyglactin can be performed with equivalent
outcomes. However, an end-to-end technique should be used for partial thickness (all

3a and some 3b) EAS tears.

9. The burying of surgical knots beneath the superficial perineal muscles is recommended
to minimize the risk of knot and suture migration to the skin.

10. The use of broad-spectrum antibiotics is recommended following repair of OASIS to

reduce the risk of postoperative infections and wound dehiscence.

11. The use of postoperative laxatives is recommended to reduce the risk of wound

dehiscence.

12. Physiotherapy following repair of OASIS could be beneficial.

13. Women who have undergone OASIS repair should be reviewed, if possible, by clinicians

with a special interest in OASIS at a convenient time (usually 6-12 weeks postpartum).

14. Most women who have sustained OASIS in a previous pregnancy are good candidates

to have a subsequent vaginal delivery, except those with abnormal symptoms or

abnormal endoanal ultrasonography/manometry whom should be counselled
regarding the option of elective caesarean birth.

Conclusion

OASIS is a significant morbidity encountered after vaginal delivery. With increased

awareness and training, the higher detection rate and standardized repair of anal sphincter
injuries can be achieved contributing to a reduction in the extent of morbidity and litigation.

Obstetric Anal Sphincter Injuries (OASIS): Impact and Management 78