Original articleA randomized comparison of suturing techniques for episiotomy and laceration repair after spontaneous vaginal birth
Section snippets
Materials and methods
This study was undertaken in a university hospital with more than 2200 deliveries per year. The static population of this district includes a wide range of socioeconomic classes and is predominately white. The local research ethics committee approved the study.
Results
From May 1 to November 19, 2003, 1135 women delivered in our department. Of them 379 women underwent caesarean sections, and 756 had vaginal delivery. Of the 756 women with vaginal delivery, only 214 (107 in the CKT group and 107 in the IT group) met the inclusion criteria and had signed the informed consent, as is shown in Figure 1.
The 2 groups were comparable at entry in important respects (Table 1). Results are shown in Table 2.
At day 10, 19 women had dropped out of the study (8 in the CKT
Discussion
Millions of women throughout the world experience pain and suffering as a result of perineal trauma sustained during delivery,18 and yet this is a very underresearched area. In Italy the perineal suture is considered a “surgical” act and, until the time this study was carried out, in our department only medical doctors could perform perineal suturing.
For nearly 70 years, researchers have been suggesting that continuous repair techniques are better than interrupted suture methods in terms of
Conclusion
The use of a continuous knotless technique for perineal repair is associated with less short-term pain than techniques with interrupted sutures. Indeed, the introduction of a continuous suturing policy would reduce overall expenditure, because less suturing material is needed than for the interrupted method of repair.
Acknowledgments
We thank the women who participated in the study and the many midwives and doctors, particularly Bruno Brusacà, Tiziana Fortunato, and Alessandra Parodi, without whose help the trial would not have been possible.
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Benefits of continuous suture of perineal injury in adaptation to motherhood
2023, Enfermeria ClinicaPerineal repair of media-lateral episiotomies and 2nd degree tears by midwives: A randomised controlled trial comparing three suture techniques
2020, International Journal of Nursing StudiesCitation Excerpt :The resulting group sample size (53) was applied to the 3 comparison groups to give a total sample size of 159 subjects. Various parameters were taken into account: a minimum expected difference between comparison groups (continuous sutures versus interrupted-discontinuous sutures) of 1 point according to the Visual Analogue Scale for Pain (VAS pain) at 10 days postpartum, with a standard deviation of 2 points taking into account that this difference was considered clinically relevant in previous studies (Morano et al., 2006); an alpha value of 0.05 in a bilateral hypothesis test; statistical power of 80%. The resulting number of cases required per group was 48.
Perineal suture practices. Are they up to date with the evidence based medicine data: A local experience into a university maternity?
2020, Journal of Gynecology Obstetrics and Human ReproductionCitation Excerpt :It identified 16 randomized controlled trials involving 8184 women from 8 countries, comparing “continuous suture methods” to “traditional discontinuous suture methods”. It was found that continuous suture techniques, compared to discontinuous methods, are associated with less pain at 10 days postpartum, as well as less need for analgesia and shorter suture removal time [8–11]. Moreover, continuous suture techniques are more cost effective than discontinuous suture methods (one thread versus two or three, respectively) [8,12].
Perineal tears and episiotomy: Surgical procedure – CNGOF perineal prevention and protection in obstetrics guidelines
2018, Gynecologie Obstetrique Fertilite et SenologieThe development and validation of a new postpartum sexual function and dyspareunia assessment tool: The Carol Scale
2018, MidwiferyCitation Excerpt :For this reason, the use of episiotomy should be restricted when attending low risk births (Previatti and de Souza, 2007; Jiang et al., 2017). In addition, the use of continuous sutures is recommended for perineal repair after childbirth given that this type of suture is associated with a lower incidence of short-term perineal discomfort (Morano et al., 2006; Almeida and Riesco, 2008; Kettle et al., 2012). However, the continuous suture technique, as endorsed by scientific evidence, has not been implemented for perineal trauma repair in our clinical practice environment.
Risk Factors for Perineal Wound Breakdown in Early Postpartum: A Retrospective Case–Control Study
2023, Journal of Clinical Medicine