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

Aim: To assess the incidence and risk factors of complete vaginal cuff wound healing at sixth and eighth week after total abdominal hysterectomy (TAH). Methods: A retrospective chart review of women who underwent TAH for benign conditions from January 2015 to December 2015 at Ramathibodi Hospital was conducted. The primary outcome was the incidence of complete vaginal cuff healing at 6 and 8 weeks after operation as determined by complete vaginal mucosal approximation without the presence of suture material or granulation tissue. Results: The medical records of 235 patients who underwent TAH for benign conditions were reviewed. The incidence of complete vaginal cuff wound healing at 6 and 8 weeks after operation were 189 and 225 cases, respectively (80.4% vs 95.7%, P value <0.001). Forty-six (19.6%) patients had incomplete vaginal cuff healing at 6 weeks after operation. Of those, 33 patients had vaginal cuff granulation. Spontaneous regression of lesions had occurred in 69.7% at 8 weeks. Independent risk factors of delay vaginal cuff healing were the used of electrosurgery for vaginal incision (adjusted odds ratio 13.4, 95% confidence interval 2.63–67.74) and suturing cuff with continuous technique (adjusted odds ratio 9.1, 95% confidence interval 2.12–39.01). Conclusion: The incidence of complete vaginal cuff wound healing was significantly higher at 8 weeks than at 6 weeks after TAH for benign conditions. Therefore, 8 weeks after operation would be an appropriate time for the first vaginal cuff examination.