Continuous versus interrupted sutures for repair of episiotomy or second-degree perineal tears
Keywords:Episiotomy, Perineal neuralgia, Suture techniques, Tear, Vaginal birth
Objective: To compare the efficacy in absorbed continuous vs interrupted suture material for repair the episiotomy and 2nd degree perineal tears in terms of time required for repair, number of suture material used and pain relief following childbirth.
Methods: A comparative randomized controlled trial was performed in Gynae & Obstetrics department of Akbar Niazi Teaching Hospital, Islamabad between May and October 2022. Total 300 patients of term delivered by spontaneous vaginal birth with episiotomy or 2nd degree perineal tear through non probability consecutive sampling were included. In group-A perineal tear was repaired with continuous non locking sutures and in group-B continuous locking sutures was done. Duration of procedures and number of suture material used was noted. Patients were followed for 24 hours for pain.
Results: The patients mean age was 24.85±3.98 years. The gestational mean age at time of delivery of all the cases was 38.79±0.84 weeks. Type of perineal trauma among all the cases was observed as 84 (28.0%) cases had 2nd degree perineal tear while 216 (72.0%) had episiotomy. Mean time required for suture repair in group-A was 9.0±0.86 sec, while in group-B, the mean time required for suture repair was 15.02±2.06 sec (p-value = 0.001). Mean suture material required for suture repair in group-A was 108.38±9.70 cm, while in group-B, the mean suture material required for suture repair was 114.01±7.17 cm (p-value = 0.001). The mean pain score in group-A was calculated as 3.64±0.94 on VAS, while in group-B mean pain was 5.46+0.75 on VAS (p-value = 0.001).
Conclusion: Through this study, it was proved that episiotomy and repair of perineal tears with continuous suture is faster, and uses less suture material without increasing complexity compared to interrupted suture. The continuous suture method of perineal repair is associated with less pain than the interrupted method.
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