Skin adhesive versus subcuticular suture for perineal skin repair after episiotomy – a randomized controlled trial

Mota, Ronaldo; Costa, Fabíola; Amaral, Alexandra; Oliveira, Fátima; Costa-Santos, Cristina; Ayres-de-Campos, Diogo

doi:10.1080/00016340902883133

Cited by 33 publications

(23 citation statements)

References 17 publications

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“…Forty‐eight randomised controlled trials, reporting data from 20 308 women, were included (Table S1). Seventeen interventions were evaluated, including different techniques (17 trials; 35%), different suture materials (six trials; 13%), and biofeedback (three studies; 6%). The majority of trials (71%) were published in general obstetrics and gynaecology journals.…”

Section: Resultsmentioning

confidence: 99%

Do we need a core outcome set for childbirth perineal trauma research? A systematic review of outcome reporting in randomised trials evaluating the management of childbirth trauma

Pergialiotis

Durnea

Elfituri

et al. 2018

BJOG

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Section: Resultsmentioning

confidence: 99%

Do we need a core outcome set for childbirth perineal trauma research? A systematic review of outcome reporting in randomised trials evaluating the management of childbirth trauma

Pergialiotis

Durnea

Elfituri

et al. 2018

BJOG

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“…Surgical adhesives have been employed for decades in other specialties, but their use in obstetrics and gynecology is relatively limited. The few published studies employing the use of surgical glue as an adjunct to perineal wound closure have shown varied results in terms of postpartum pain. In all of these studies, the vaginal incision and deep perineal tissues were sutured, and the perineal skin was closed using a surgical adhesive.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent randomized controlled trial comparing the use of surgical adhesive to suture repair of first‐degree perineal lacerations, Feigenberg et al reported less pain, shorter procedure time, and greater patient satisfaction with surgical glue . A randomized trial by Mota et al found no difference in pain between perineal skin closure with suture versus surgical adhesive following mediolateral episiotomy . However, deep pain related to mediolateral episiotomy could have masked skin‐related pain in this study, which may explain why no difference in pain scores was identified between the 2 perineal skin closure methods.…”

Section: Discussionmentioning

confidence: 99%

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Randomized Trial of 3 Techniques of Perineal Skin Closure During Second‐Degree Perineal Laceration Repair

Swenson

Low

Kowalk

et al. 2019

J Midwife Womens Health

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Introduction: Perineal lacerations during childbirth are common, and suturing the perineal skin during repair has been associated with increased postpartum pain. This study sought to test the hypothesis that no difference in postpartum perineal pain exists between 3 methods of skin closure for second-degree repair: suture, no suture, and surgical glue.Methods: A single-blind randomized controlled trial of women after vaginal birth who had a second-degree perineal laceration was conducted at a tertiary care teaching hospital from August 2014 to April 2017. Women were randomized to perineal skin closure with suture, no suture, or surgical glue using a 1:1:1 allocation. Pain was assessed using the short-form McGill Pain Questionnaire, a 100-mm visual analog scale (VAS), and Present Pain Index (PPI) at one day, 2 weeks, 6 weeks, and 3 months postpartum. Wound healing was assessed at 6 weeks using the Redness, Edema, Ecchymosis, Drainage, Approximation (REEDA) scale. Pain scores were compared across groups using a chi-square test, Mann-Whitney U test, or analysis of variance where appropriate. Results:A total of 35 women were randomized: 14 received suture, 11 had no suture, and 10 received surgical glue for perineal skin repair. Demographic characteristics were similar between groups. At 2 weeks postpartum, women with suture had higher median pain scores on the short-form McGill Pain Questionnaire (15.0 suture vs 2.0 glue vs 2.0 no suture, P = .03) and VAS (50.0 suture vs 3.0 glue vs 7.0 no suture, P = .02). Significant differences in pain were not seen on the PPI. At 3 months, women in the suture group had higher median pain scores on the short-form McGill Pain Questionnaire compared with surgical glue (1.0 vs 0, P = .04). Wound healing was similar across groups (REEDA score: 0 suture vs 1.0 no suture, vs 0 surgical glue, P = .24). Discussion:Compared with no suture and surgical glue, suturing the perineal skin was associated with the highest postpartum pain scores.

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“…Up to our knowledge the current study is the first to compare skin adhesive tape with the interrupted absorbable suture technique in episiotomy skin closure, yet other studies compared adhesive glue to sutures as [14] and [4], targeting a heterogeneous sample of primiparous and multiparous with a total number of 100 and 97 women respectively both supported the potential benefits of glue use, as a better alternative to sutures as regards procedure time and reduced pain sensation although there was insignificant difference between both groups at 7 and 30 days [14]. However, the cost of glue use may be an issue especially in a developing country with limited resources like Egypt, while [15] and [8] reported increase in pain sensation in the sutured arm when comparing skin adhesive tape to suturing the skin in surgeries other than obstetric.…”

Section: Discussionmentioning

confidence: 99%

Skin-Adhesive Tape versus Interrupted Suture in Episiotomy Skin Repair: Randomized Control Trial

Sherif¹,

El-Shourbagy²

2020

OJOG

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Introduction: The ideal method for perineal repair should be quick, easy to perform and preferably, with minimal pain. Aim: To compare skin adhesive tape and interrupted absorbable subcuticular suture for episiotomy repair after birth as regard postoperative pain, skin closure time and wound infection. Design: Prospective double-blinded randomized controlled trial. Methods: Three-hundred qualified patients were equally distributed between two groups. Group 1 underwent skin repair with skin adhesive tape, while group 2 underwent the currently traditional method for perineal repair by interrupted suture. Pain was evaluated at 2, 4, 6 and 12 hours after birth then daily until one week using Wong-Baker faces pain rating scale with verbal expression for pain intensity as primary outcome. Skin closure time and wound infection were also evaluated as secondary outcomes. Results: Statistically significant difference in pain was found at 4 and 6 hours, and 3, 4, 5 and 7 days after perineal repair in favor of the adhesive tape group (p = 0.04 and 0.02 respectively) (p = 0.002, 0.002, 0.003 and 0.001 respectively). No statistically significant difference was found in skin closure time between both groups, and no cases of wound infection occurred in both groups (p = 0.3). Conclusion: Skin adhesive tape may be superior to skin suturing in decreasing pain resulting from perineal repair after birth; however, further studies are needed to assess long-term effects, calculate costs and accurately measure patients' satisfaction, which were not addressed in this study.

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Skin adhesive versus subcuticular suture for perineal skin repair after episiotomy – a randomized controlled trial

Abstract: Perineal skin closure using adhesive glue is faster than subcuticular suture, and associated with a similar incidence of complications and pain in the first 30 days.

Cited by 33 publications

References 17 publications

Do we need a core outcome set for childbirth perineal trauma research? A systematic review of outcome reporting in randomised trials evaluating the management of childbirth trauma

Do we need a core outcome set for childbirth perineal trauma research? A systematic review of outcome reporting in randomised trials evaluating the management of childbirth trauma

Randomized Trial of 3 Techniques of Perineal Skin Closure During Second‐Degree Perineal Laceration Repair

Skin-Adhesive Tape versus Interrupted Suture in Episiotomy Skin Repair: Randomized Control Trial

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