🤱 Perineal Tear & Episiotomy Healing Grade Simulator

Grade I: First-Degree Perineal Tear

Shallow injury to skin and mucosa only, usually healing fast.

• ~2 mm: Depth (skin/mucosa)
• ~14 days: Healing time (typical)
• Often none: Suturing (or minimal)
• 1–2%: Incontinence risk (low)

What defines Grade I

Superficial tear of fourchette, perineal skin, vaginal mucosa only.

Grade II: Second-Degree Tear

Extends into perineal muscles but the anal sphincter stays intact.

• ~8 mm: Depth (muscle layer)
• ~21 days: Healing time (typical)
• Layered repair: Suturing (usually needed)
• 5–10%: Incontinence risk (moderate)

What defines Grade II

Most common obstetric tear; includes most episiotomies.

Grade III: Anal Sphincter Injury

Obstetric anal sphincter injury (OASIS) affecting continence muscles.

• ~15 mm: Depth (sphincter complex)
• ~35 days: Healing time (typical)
• 3a–3c: Subtypes (% torn)
• 20–30%: Incontinence risk (elevated)

What defines Grade III

Partial or complete tear of external/internal anal sphincter.

Grade IV: Full-Thickness Rectal Injury

Most severe tear, breaching the rectal mucosa itself.

• ~25 mm: Depth (full thickness)
• ~56 days: Healing time (typical)
• OR repair: Repair (specialist required)
• 30–60%: Incontinence risk (high)

What defines Grade IV

Tear continuous through sphincter into rectal lumen mucosa.

Healing Timelines Across Severity Grades

Recovery duration scales strongly with initial tissue damage depth.

• 14 d: Grade I (healing window)
• 21 d: Grade II (healing window)
• 35 d: Grade III (healing window)
• 56 d: Grade IV (healing window)

Comparing recovery curves

Higher grades need longer tissue remodeling and closer monitoring.

Severe tears warrant structured follow-up and pelvic floor rehab.