Repair of Episiotomy, First and Second Degree Tears

Kettle, Christine; Fenner, Dee E.

doi:10.1007/978-1-84628-503-5_3

Cited by 11 publications

(13 citation statements)

References 35 publications

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“… 2 Use of a rapidly absorbable form of polyglactin 910 for the repair of perineal trauma offers a significant reduction in pain and analgesic number, when compared to standard absorbable synthetic material. 11 Polyglactin 910 elicits minimal tissue reaction as compared to catgut, and is associated with less pain. 6 A decrease in perineal pain and analgesic requirement with the use of a rapidly absorbable synthetic suture material was reported in previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Perineal wound heals by primary closure, with least possible complications within 14 days of suturing. 11 Episiotomy repair with polyglactin 910 suture results in more satisfactory wound healing as compared to chromic catgut suture. 8 A non-significant, but faster wound healing was noted in Trusynth Fast ® group as compared to Vicryl Rapide ® group.…”

Section: Discussionmentioning

confidence: 99%

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Clinical equivalence of Trusynth fast® and Vicryl rapide® polyglactin 910 fast absorbing sutures on maternal morbidity experienced by women following episiotomy repair: a single-blind, randomized study

Devi¹,

Bolanthakodi

D’Cunha

et al. 2023

F1000Res

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Background: Episiotomy procedure enlarges the vaginal outlet to facilitate childbirth. Polyglactin 910 fast-absorbing sutures are widely used for the repair of episiotomy because of their rapid absorption and less inflammatory response. This study was designed for subjective assessment of perineal pain post-episiotomy repair, with Trusynth Fast® and Vicryl Rapide® polyglactin 910 fast-absorbing sutures. Method: This was a single-blind, randomized, prospective study conducted between January 7, 2021 and July 14, 2021 across two centers in India. Primiparous or multiparous women (18—40 years), who required episiotomy during vaginal delivery were included, and either Trusynth Fast® (n=47) or Vicryl Rapide® (n=49) suture was used for their episiotomy repair. The primary endpoint, perineal pain was assessed with visual analogue scale at all follow-up visits. The secondary endpoints, quantity of local anesthesia, number of sutures used, time to repair episiotomy, intraoperative suture handling, analgesics used, early and late wound complications, wound re-suturing, time to complete healing, presence of residual sutures, return to sexual activity, dyspareunia, and adverse events were also recorded. Results: The study showed no significant difference in perineal pain between the two groups at any visit. A statistically significant difference (p<0.05) in total score of episiotomy healing scale on day 2 (0.13±0.34 versus 0.35±0.56) and swelling on day 2 (8.51 versusversus 28.57%) was noted between Trusynth Fast® and Vicryl Rapide® group. Non-significant difference was observed between the groups regarding anesthesia, number of sutures, time to repair episiotomy, intraoperative suture handling, analgesics, puerperal fever, wound infection, dehiscence, hematoma, urinary incontinence, re-suturing, time to complete healing, return to sexual activity and dyspareunia. Conclusion: Trusynth Fast® suture is clinically equivalent to Vicryl Rapide® suture and can be used for episiotomy repair with minimal risk of perineal pain and wound complications. Clinical Trials Registry of India Registration: CTRI/2020/12/029925; Registered on December 18, 2020

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical equivalence of Trusynth fast® and Vicryl rapide® polyglactin 910 fast absorbing sutures on maternal morbidity experienced by women following episiotomy repair: a single-blind, randomized study

Devi¹,

Bolanthakodi

D’Cunha

et al. 2023

F1000Res

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“…[3][4][5][6][7][8] Perineal trauma may be indirectly associated with long-term maternal morbidity (urinary incontinence, dyspareunia, psychological problems) but these are multifactorial with no direct causal association. [9][10][11][12][13] 2 | METHODS An in-depth exploratory mixed-methods study was undertaken in one urban National Health Service tertiary hospital in the South of England (5000-6000 births per year). Qualitative data were included to provide insight into women's experiences of wound problems because "maternal satisfaction" is included as a "core outcome set" in the Core Outcome Measures in Effectiveness Trials initiative's consensus on minimum outcomes for maternity research.…”

Section: Introductionmentioning

confidence: 99%

“…Complications of perineal trauma include pain, infection and wound breakdown . Perineal trauma may be indirectly associated with long‐term maternal morbidity (urinary incontinence, dyspareunia, psychological problems) but these are multifactorial with no direct causal association …”

Section: Introductionmentioning

confidence: 99%

Infection and wound breakdown in spontaneous second‐degree perineal tears: An exploratory mixed methods study

Wiseman

Rafferty

Stockley

et al. 2018

Birth

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“…The official classification of perineal tears was developed by Abdul Sultan, a United Kingdom (UK) obstetrician, in 1999 (Table 1) and is the standard used in professional UK guidelines (National Collaborating Centre for Women's and Children's Health [NICE], 2006;; Royal College of Midwives [RCM], 2012a; 2012b; Royal College of Obstetricians and Gynecologists [RCOG], 2004;. The extent of the tear and the number of tissue layers define the categories (Kettle & Fenner, 2007) and are predictive of the magnitude of difficulty of repair and postpartum morbidity (RCOG, 2007).…”

Section: Introductionmentioning

confidence: 99%

New Zealand midwives' management of perineal trauma during childbirth: A survey of practice

Cronin¹

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<p>Background: Perineal trauma is the most common complication of vaginal birth and how this is treated has an impact on the incidence and duration of pain and dysfunction. Responsibility for the management of women’s perinea after uncomplicated births in New Zealand ordinarily rests with midwives although this is a little known aspect of practice. This study aimed to identify how midwives assess and manage second degree perineal trauma, the level to which their practice reflects best evidence, and what influences midwives’ decision-making. Methods: A descriptive approach using an online survey of 75 questions was used to access the population of 2910 New Zealand midwives. Inclusion criterion was current perineal management. Quantitative data were collected and associations examined using chi-square and Fisher’s exact test. Interval data were analysed with a two-sample t-test. Results: 818 midwives returned a questionnaire, 744 (25% of the midwifery population) met the inclusion criteria. Evidence-based suturing material for repair of the last second degree tear was used by 96%. Correct suturing technique throughout all layers of repair was 42%. Rectal examination during assessment was performed by 45% increasing to 86% after repair. Confidence to repair was directly related to years since midwifery qualification (p<.001) and self-employment (p<.001). The tear was left unsutured by 7% and associated with reduced confidence with repair (p<.001), lack of recent experience with repair (p<.001), and home birth (p=.002). Unsutured tears were shorter than sutured tears (vaginal/perineal length, p<.001; depth, p=.004) and associated with delayed healing (p=.034). Care to six weeks postpartum was provided by 377 midwives. Perineal analgesia included oral medication (76%), pelvic floor exercises (44%), cooling (38%), and suppositories (31%). Visual assessments of healing were performed by 84% of midwives, 49% of women, and 7% of support people. Complications of infection (2%), pain (2%), and healing delay (3%) were uncommon. Conclusions: This research has added a New Zealand midwifery practice perspective to the existing literature on second degree perineal care. Potential for reductions in perineal morbidity were identified, even though New Zealand midwifery care already has a low rate of complications compared to international studies.</p>

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Repair of Episiotomy, First and Second Degree Tears

Cited by 11 publications

References 35 publications

Clinical equivalence of Trusynth fast® and Vicryl rapide® polyglactin 910 fast absorbing sutures on maternal morbidity experienced by women following episiotomy repair: a single-blind, randomized study

Clinical equivalence of Trusynth fast® and Vicryl rapide® polyglactin 910 fast absorbing sutures on maternal morbidity experienced by women following episiotomy repair: a single-blind, randomized study

Infection and wound breakdown in spontaneous second‐degree perineal tears: An exploratory mixed methods study

New Zealand midwives' management of perineal trauma during childbirth: A survey of practice

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