Absorbable Stitches for Repair of Episiotomy and Tears

8/18/2019 Absorbable Stitches for Repair of Episiotomy and Tears

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Absorbable stitchesfor repair of

episiotomy and tearsat childbirth


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Background

Approximately 70% of women will experience perinealtrauma following vaginal delivery and will requirestitches.

This may result in pain, suture removal and superficialdyspareunia.


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Objectives

To assess the effects of different suturematerials on short- and long-termmoridity following perineal repair.


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Search methods

!ochrane "regnancy and !hildirth#roup$s Trials egister weresearched&'eruary (0)0*.


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Selection criteria

andomised trials comparing differentsuture materials for perineal repair aftervaginal delivery.


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Data collection and analysis

Two review authors independentlyassessed trial quality and extracted data.


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Main results

)+ trials with )0,)7) women was included

comparisons included

catgut with standard synthetic ( trials!"

rapidly absorbing synthetic versus standard synthetic sutures

(# trials! Standard catgut versus glycerol impregnated catgut(two

trials!$

Absorbable monofilament sutures versus standardpolyglycolic


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Absorbable synthetic sutures versus catgut% trialswith #&' women

n trials comparing standard asorale synthetic sutures with catgut,fewer women with synthetic sutures experienced pain.

n those trials examining analgesia use up to )0 days, women with syntheticsutures had less analgesia than those with catgut sutures

/ore women with catgut sutures required resuturing &)1)(0)* comparedwith synthetic sutures21)(0)**

while more women with standard synthetic sutures required the removal ofunasored suture material


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)ast absorbing versus standard synthetic sutures% fivetrials with *+, women

There was no significant evidence of any difference etween groups sutured with standard versurapidly asoring sutures in the numers of women experiencing perineal pain at2() up to three dafter delivery

3imilarly, differences etween groups for perineal pain at )0 to )4 days were not statistically sig

5se of analgesia for perineal pain was reported in one trial, and fewer women with rapidly asorsutures were using analgesics at )0 days post delivery

6omen sutured with fast-asoring synthetic sutures were more liely to have wound sin edgesat up to )0 days,compared with those with standard synthetic sutures

Three women sutured with fast-asoring material required resuturing compared with one womastandard synthetic sutures

/ore women with standard sutures required the removal of suture material compared with thoserapidly asoring stitches


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Standard catgut versus glycerol impregnated catgut%two trials with '*' women

"ain at three days after delivery was examined in one trial and there was no evidence any difference etween groups sutured with either chromic catgut or glycerol impregcatgut &3oftgut*

At )0 to )4 days pain was measured in two trials and 3oftgut was associated with morwomen experiencing pain,

There was no significant difference in the numer of women with wound dehiscence a

days

/ore women with standard catgut required the removal of suture material y three m

Approximately (%of women continued to experience dyspareunia three months afterirth of their aies.


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Absorbable monofilament sutures versus standardpolyglycolic% one trial with *, women

8nly one trial contriuted data to this outcome .

There was no evidence of any differences in mean pain scores for womenrepaired with synthetic monofilament sutures or polyglycolic acid suturesat one to three days after delivery.

There was no strong evidence of any difference etween group for pain at

eight to )( wees .

6omen sutured with monofilament material were more liely to report9wound prolems: at eight to )( wees .

8ne woman in each group had wound readown requiring resuturing.


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Absorbable Stitches for Repair of Episiotomy and Tears

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