Wound assessment is a vital and dynamic process that can ensure women receive appropriate care to optimise wound healing. It is part of the midwife’s role to provide wound care for women who have had perineal trauma and caesarean section. Midwives need to be competent in wound assessment, using a holistic approach to identify any issues that may be preventing the wound from healing well. The use of a standardised assessment tool may be helpful. For example, the Southampton wound scoring system. Stages of wound healing are shown in Table 67.1.
Assessment of the perineal wound is one area that is often neglected in practice leading, potentially, to ongoing health issues such as perineal wound infections and dehiscence. Similarly, the increase in caesarean births has also triggered a rise in wound care management issues for midwives, such as potential surgical site infections. The burden of wound infections includes maternal mortality, morbidity and lengthy hospital stay, all of which have cost implications. Like all wounds, the healing process is affected by physical, economic, social, psychological, emotional and environmental factors.