Continuous versus interrupted perineal repair with standard or rapidly absorbed sutures after spontaneous vaginal birth: a randomised controlled trial.
Background: Trauma to the perineum is a serious and frequent problem after childbirth, with about 350000 women each year in the UK needing sutures for perineal injury after spontaneous vaginal delivery, and many millions more worldwide. We compared the continuous technique of perineal repair with th...
| Publicado en: | Lancet Vol. 359; no. 9325; pp. 2217 - 2224 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | pictorial research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Lancet
6/29/2002
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106950317&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106950317 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 6/29/2002 vid: 359 iid: 9325 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 106950317 106950317 NLM12103284 2002086482 10.1016/s0140-6736(02)09312-1 NLM12103284 106950317 ppf: 2217 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Continuous versus interrupted perineal repair with standard or rapidly absorbed sutures after spontaneous vaginal birth: a randomised controlled trial. aug: au: Kettle C Hills RK Jones P Darby L Gray R Johanson R Kettle, Christine Hills, Robert K Jones, Peter Darby, Louisa Gray, Richard Johanson, Richard affil: Academic Department of Obstetrics and Gynaecology, Women and Children's Division, City General Site, Stoke on Trent ST4 6QG, UK sug: subj: Perineum Surgery Suture Techniques Vaginal Birth Adult Clinical Trials Confidence Intervals Episiotomy Factorial Design Female Certified Nurse Midwives Odds Ratio Postnatal Period Postoperative Pain Pregnancy Questionnaires United Kingdom Funding Source Human Adult: 19-44 years Female ab: Background: Trauma to the perineum is a serious and frequent problem after childbirth, with about 350000 women each year in the UK needing sutures for perineal injury after spontaneous vaginal delivery, and many millions more worldwide. We compared the continuous technique of perineal repair with the interrupted method, and the more rapidly absorbed polyglactin 910 suture material with the standard polyglactin 910 material. Methods: 1542 women who had a spontaneous vaginal delivery with a second-degree perineal tear or episiotomy were randomly allocated to either the continuous (n=771) or interrupted (771) suturing method, and to either the more rapidly absorbed polyglactin 910 suture material (772) or standard polyglactin 910 material (770). Primary outcomes were pain 10 days after delivery and superficial dyspareunia 3 months postpartum. Analysis was by intention to treat. Findings: At day 10, three women had dropped out of the study. Significantly fewer women reported pain at 10 days with the continuous technique than with the interrupted method (204/770 [26.5%] vs 338/769 [44.0%], odds ratio 0.47, 95% CI 0.38-0.58, p<0.0001). Occurrence of pain did not differ significantly between groups assigned the more rapidly absorbed material or standard material (256/769 [33.3%] vs 286/770 [37.1%], 0.84, 0.68-1.04, p=0.10). Women reported no difference in superficial dyspareunia at 3 months for the continuous vs the interrupted method (98/581 [16.9%] vs 102/593 [17.2%], 0.98, 0.72-1.33, p=0.88) or the more rapidly absorbed versus standard material (105/586 [17.9%] vs 95/588 [16.2%], 1.13, 0.84-1.54, p=0.42). Suture removal was done less with the more rapidly absorbed material than with standard suture material (22/769 [3%] vs 98/770 [13%], p<0.0001), and with the continuous versus interrupted method (24/770 [3%] vs 96/769 [12%], p<0.0001). Interpretation: A simple and widely practicable continuous repair technique can prevent one woman in six from having pain at 10 days. Also, the more rapidly absorbed polyglactin 910 material obviates need for suture removal up to 3 months postpartum for one in ten women sutured. pubtype: Academic Journal doctype: pictorial research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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