OBJECTIVE: To evaluate the repair techniques of continuous and interrupted methods for episiotomy or perineal tears. DESIGN: A randomised controlled trial. SETTING: The Hospital Universitario Principe de Asturias, a state hospital belonging to the community of Madrid. SAMPLE: Four hundred forty-five women who had undergone vaginal deliveries with episiotomies or second-grade tearing of the perineum between September 2005 and July 2007. METHODS: One group was repaired with continuous, nonlocking sutures involving the vagina, perineum, and subcutaneous tissues. The other group had continuous, locking sutures of the vagina, interrupted sutures in the perineal muscles, and interrupted transcutaneous sutures. The threads used for stitching were identical in both groups. MAIN OUTCOME MEASURES: The participants were questioned regarding the sensation of pain and the use of painkillers on the second and the tenth days, and 3 months postpartum. RESULTS: When comparing the group with continuous suture to the group with interrupted sutures, the differences included less repair time (1 minute; P= 0.017) and less suture material used (relative risk [RR], 3.2, 95% CI: 2.6-4.0). The comparison of pain on the second and tenth days, and 3 months postpartum were not statistically different between the two techniques (RR, 1.08, 95% CI: 0.74-1.57; RR, 0.96, 95% CI: 0.59-1.55; and RR, 0.68, 95% CI: 0.19-2.46, respectively). CONCLUSIONS: Although we did not demonstrate that one technique was better than the other in the incidence of pain in the short or long term, we showed that episiotomy and perineal tear repairs with continuous suturing were quicker and used less suture material without an increase in complication than interrupted suturing.
RCT Entities:
OBJECTIVE: To evaluate the repair techniques of continuous and interrupted methods for episiotomy or perineal tears. DESIGN: A randomised controlled trial. SETTING: The Hospital Universitario Principe de Asturias, a state hospital belonging to the community of Madrid. SAMPLE: Four hundred forty-five women who had undergone vaginal deliveries with episiotomies or second-grade tearing of the perineum between September 2005 and July 2007. METHODS: One group was repaired with continuous, nonlocking sutures involving the vagina, perineum, and subcutaneous tissues. The other group had continuous, locking sutures of the vagina, interrupted sutures in the perineal muscles, and interrupted transcutaneous sutures. The threads used for stitching were identical in both groups. MAIN OUTCOME MEASURES: The participants were questioned regarding the sensation of pain and the use of painkillers on the second and the tenth days, and 3 months postpartum. RESULTS: When comparing the group with continuous suture to the group with interrupted sutures, the differences included less repair time (1 minute; P= 0.017) and less suture material used (relative risk [RR], 3.2, 95% CI: 2.6-4.0). The comparison of pain on the second and tenth days, and 3 months postpartum were not statistically different between the two techniques (RR, 1.08, 95% CI: 0.74-1.57; RR, 0.96, 95% CI: 0.59-1.55; and RR, 0.68, 95% CI: 0.19-2.46, respectively). CONCLUSIONS: Although we did not demonstrate that one technique was better than the other in the incidence of pain in the short or long term, we showed that episiotomy and perineal tear repairs with continuous suturing were quicker and used less suture material without an increase in complication than interrupted suturing.
Authors: Margarita Manresa; Ana Pereda; Eduardo Bataller; Carmen Terre-Rull; Khaled M Ismail; Sara S Webb Journal: Int Urogynecol J Date: 2019-02-15 Impact factor: 2.894