If a third degree tear is not repaired to a good standard shortly after the birth, there may be a case of medical negligence. Contact a solicitor to find out more.
How to repair a third degree tear
A third degree tear must be repaired in theatre by an experienced surgeon. The technique used will depend upon the type of third degree tear that has been sustained. There are different types of third degree tear that are classified according to the extent of the injury. They can be defined as follows:
- 3a: partial tear of the external sphincter involving less than 50% thickness;
- 3b: tear of the external sphincter involving more than 50% thickness;
- 3c: external and internal sphincter torn.
With a 3a or 3b tear, it is acceptable to repair the external sphincter using either an end-to-end technique or the overlapping technique. However, the internal sphincter cannot be overlapped as it is adherent to the anal mucosa. Therefore with a 3c tear, the most appropriate technique is to repair the internal sphincter separately by interrupted or mattress sutures and then repair the external sphincter over the internal sphincter.
When to repair a third degree tear?
A third degree tear should be repaired shortly after the birth. If a theatre is not available in the period following the delivery, a repair should be scheduled for shortly thereafter – certainly before a patient is discharged from hospital.
A repair that is performed shortly after the injury is sustained is called a primary repair. There will be persistent anal defects in around 85% of women who have had a primary repair, but only some women will develop anal incontinence. Therefore as long as a patient has a primary repair, there is a good chance that she will regain normal function.
The likelihood of regaining normal function is much reduced if a secondary repair is carried out, meaning a repair performed months or years after the injury was incurred. Women who do not have a primary repair will be left with a defect in their sphincter, causing them to experience difficulties when controlling the passing of wind and faeces. This can lead to episodes of incontinence.
Failure to repair a third degree tear
If medical practitioners fail to repair a third degree tear shortly after the birth, or fail to perform a competent repair, there will be a case of medical negligence. This means the patient concerned will be able to pursue a claim for compensation. Contact us today to find out more.