Continuous versus interrupted sutures for repair of episiotomy or second degree tears

Kettle, Christine; Hills, Robert Kerrin; Ismail, Khaled

doi:10.1002/14651858.cd000947.pub2

Cited by 77 publications

(52 citation statements)

References 20 publications

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“…The pain and the dyspareunia, both at short and long term, were similar according to the women. Although our results contradict the recent meta-analysis of the Cochrane database, 15 our conclusions agree with those of a more published study 17 that compared continuous and interrupted skin sutures. The difference between these results and those obtained in the meta-analysis is probably attributable to the homogeneity of the health personnel in terms of their skill in performing the repair and the method of concealment used in the repair of the perineum, as well as the person who conducted the interview, and even the patient herself.…”

Section: Discussionsupporting

confidence: 74%

“…In a recent meta-analysis 15 that included seven clinical trials involving health personnel who differed in their ability to repair episiotomies, it was found that the continuous suture technique was associated with less pain in the short term compared with the discontinuous technique. Kettle et al 16 carried out a trial comparing the two techniques of episiotomy repair (continuous and discontinuous) using two suture materials (quick absorption and standard) and found that less pain was experienced with the continuous suture technique.…”

Section: Discussionmentioning

confidence: 99%

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Continuous versus interrupted sutures for repair of episiotomy or second‐degree perineal tears: a randomised controlled trial

Valenzuela

Puente

Valero

et al. 2009

BJOG

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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). ConclusionsAlthough 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.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Continuous versus interrupted sutures for repair of episiotomy or second‐degree perineal tears: a randomised controlled trial

Valenzuela

Puente

Valero

et al. 2009

BJOG

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“…Similar observations were made by Kettle C et al who reported that the continuous subcuticular technique of perineal repair may be associated with less pain in the immediate postpartum period than the interrupted suture technique and Almeida SF et al found that perineal pain due to palpation at four days after delivery was more frequent among women with interrupted suture. 5,6 Kokanalı D et al also reported that the continuous suturing techniques for episiotomy closure, compared to interrupted methods, are associated with less short-term pain, are quicker and also need less suture material. 7 In the present study, on 10th day perception of pain during sitting and walking revealed that more subjects had moderate to severe pain in interrupted group which was statistically significant (p value 0.027).…”

Section: Discussionmentioning

confidence: 99%

“…6 Kettle C et al reported that there was no difference in long-term pain and the continuous technique was associated with less need for the removal of sutures. 5 The Mahomed trial reported a non-significant increase in long-term pain in the continuous subcutaneous sutures for perineal skin closure group compared to the interrupted transcutaneous group, (RR 1.10, 95% CI 0.77 to 1.57).…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of continuous and interrupted suturing techniques for repair of episiotomy or second degree perineal tear

Samal

Rathod

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Perineal trauma is a serious and frequent problem after childbirth which is experienced by millions of women worldwide and the type of perineal repair may have an impact on pain and healing. The objective of this study was to assess the effects of continuous subcuticular versus interrupted transcutaneous sutures on women following episiotomy or second degree perineal repair following childbirth.Methods: A prospective comparative study comprising 141 women who had undergone vaginal deliveries with episiotomies or second-degree tearing of the perineum between August 2015 and July 2016Two groups were made among which one group was repaired with continuous, nonlocking sutures involving the vagina, perineum, and subcutaneous tissues and 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 i.e. rapidly absorbed polyglactin 910 suture material.Results: On the 2nd day after delivery, the perineal pain scores during lying, sitting and walking in the continuous technique(CT) group was less compared to the interrupted technique(IT) group(p value 0.009). On 10th day after delivery the perineal pain score during sitting and walking were statistically less (p value 0.027) in the CT group. On 42th day there was no difference in pain score between both the groups. The amount of suture materials consumed in CT group was statistically less than IT group(p<0.001). There was no difference in incidence of wound dehiscence (p value 0.301) but superficial dyspareunia is more in IT group which is statistically significant.Conclusions: The episiotomy and perineal tear repairs with continuous suturing associated with lesser incidence of short or long term pain, lesser requirement of suture material without an increase in complication than interrupted suturing.

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“…It is a type of 2º perineal tear. [1] The first recorded procedure was done by Ould. [2] Two types of episiotomies are performed nowadays, median (Midline) and mediolateral [ Figure 1].…”

Section: Introductionmentioning

confidence: 99%

Routine Episiotomy Causes More Morbidity in Parous Women, a Case Controlled Study Conducted in Kannur Medical College

Asokan¹,

Santhosh²

2016

jemds

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AIM OF STUDYEpisiotomy is a surgical procedure done to assist delivery, which is widely practiced world over. This is a comparative study with episiotomy and without episiotomy during vaginal delivery. The aim of the present study is to show routine episiotomy in the multiparous ladies is not a boon but a bane. MATERIALS AND METHODSSamples are collected during from 2010 to 2014. Total 500 cases were selected for study purpose; 250 cases underwent episiotomy during second stage of labor and 250 cases without episiotomy. Inclusion CriteriaInclusion Criteria are parity equal to and more than two. Exclusion CriteriaExclusion criteria are risk factors like obstetric complications, medical complications and previous caesarean delivery. CONCLUSIONEpisiotomy in multiparous ladies causes more morbidity than in ladies without episiotomy. Hospital stay also increased in episiotomy cases.

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Continuous versus interrupted sutures for repair of episiotomy or second degree tears

Cited by 77 publications

References 20 publications

Continuous versus interrupted sutures for repair of episiotomy or second‐degree perineal tears: a randomised controlled trial

Continuous versus interrupted sutures for repair of episiotomy or second‐degree perineal tears: a randomised controlled trial

Comparative analysis of continuous and interrupted suturing techniques for repair of episiotomy or second degree perineal tear

Routine Episiotomy Causes More Morbidity in Parous Women, a Case Controlled Study Conducted in Kannur Medical College

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