Absorbable suture materials for primary repair of episiotomy and second degree tears

Abstract

Comparison 1 Synthetic sutures versus catgut, Outcome 6 Resuturing of wound-up to 3 months.. . Analysis 1.7. Comparison 1 Synthetic sutures versus catgut, Outcome 7 Removal of suture material-up to 3 months. Analysis 1.8. Comparison 1 Synthetic sutures versus catgut, Outcome 8 Long-term pain-at 3 months postpartum.. Analysis 1.9. Comparison 1 Synthetic sutures versus catgut, Outcome 9 Dyspareunia-at 3 months postpartum.. . Analysis 2.1. Comparison 2 Fast-absorbing synthetic versus standard absorbable synthetic material, Outcome 1 Short-term

Optimizing and enhancing perineal repair knowledge and teaching among obstetricians and midwives: A prospective three‐site study

“…This may represent a delay in the filtration of up‐to‐date evidence into clinical settings, and may indeed result in trainees being taught by trainers who are practicing older and outdated techniques. Our teaching reinforced the up‐to‐date guidance from international collegiate bodies, as well as evidence supported by meta‐analyses 24,29,30,33 …”

“…Our teaching reinforced the up-to-date guidance from international collegiate bodies, as well as evidence supported by meta-analyses. 24,29,30,33 Our work also highlights that almost one in 10 practitioners were left-hand dominant. During our teaching intervention we noted that the majority of teaching tools available (videos, materials, and surgical instructions) were all targeted to a right-handed surgeon.…”

“…Our respondents revealed a number of areas with excellent compliance but also revealed areas where practice was mixed and somewhat outdated. An excellent example of compliance with international grade 1 evidence by a Cochrane review was in the use of absorbable synthetic suture material 24,25 . Our cohort of respondents were 100% compliant with current best practice using absorbable braided sutures for perineal repair.…”

“…A Cochrane meta‐analysis suggests that the preferred technique for repairing the vagina, perineal muscles, and skin is continuous nonlocking suturing. The evidence for this technique includes reduced short‐term pain, decreased need for analgesia, improved sexual function, fewer postnatal suture removals, and greater cost‐effectiveness 24,27,28 . 85.4% of our study participants used this continuous nonlocking technique at the level of the vaginal mucosa, and 80.9% used it (specifically a subcuticular version of this technique) for the skin.…”

Optimizing and enhancing perineal repair knowledge and teaching among obstetricians and midwives: A prospective three‐site study

“…This may represent a delay in the filtration of up‐to‐date evidence into clinical settings, and may indeed result in trainees being taught by trainers who are practicing older and outdated techniques. Our teaching reinforced the up‐to‐date guidance from international collegiate bodies, as well as evidence supported by meta‐analyses 24,29,30,33 …”

“…Our teaching reinforced the up-to-date guidance from international collegiate bodies, as well as evidence supported by meta-analyses. 24,29,30,33 Our work also highlights that almost one in 10 practitioners were left-hand dominant. During our teaching intervention we noted that the majority of teaching tools available (videos, materials, and surgical instructions) were all targeted to a right-handed surgeon.…”

“…Our respondents revealed a number of areas with excellent compliance but also revealed areas where practice was mixed and somewhat outdated. An excellent example of compliance with international grade 1 evidence by a Cochrane review was in the use of absorbable synthetic suture material 24,25 . Our cohort of respondents were 100% compliant with current best practice using absorbable braided sutures for perineal repair.…”

“…A Cochrane meta‐analysis suggests that the preferred technique for repairing the vagina, perineal muscles, and skin is continuous nonlocking suturing. The evidence for this technique includes reduced short‐term pain, decreased need for analgesia, improved sexual function, fewer postnatal suture removals, and greater cost‐effectiveness 24,27,28 . 85.4% of our study participants used this continuous nonlocking technique at the level of the vaginal mucosa, and 80.9% used it (specifically a subcuticular version of this technique) for the skin.…”

Acute pain management after vaginal delivery with perineal tears or episiotomy

“…A meta-analysis published in 2010 included 18 RCTs comparing different suture materials for perineal repair after a vaginal delivery 86. Comparing standard synthetic with rapidly absorbing sutures, no difference in pain intensity was observed between the groups, but more women required suture removal in the standard synthetic suture group.…”

Optimizing and enhancing perineal repair knowledge and teaching among obstetricians and midwives: A prospective three‐site study

“…This may represent a delay in the filtration of up‐to‐date evidence into clinical settings, and may indeed result in trainees being taught by trainers who are practicing older and outdated techniques. Our teaching reinforced the up‐to‐date guidance from international collegiate bodies, as well as evidence supported by meta‐analyses 24,29,30,33 …”

“…Our teaching reinforced the up-to-date guidance from international collegiate bodies, as well as evidence supported by meta-analyses. 24,29,30,33 Our work also highlights that almost one in 10 practitioners were left-hand dominant. During our teaching intervention we noted that the majority of teaching tools available (videos, materials, and surgical instructions) were all targeted to a right-handed surgeon.…”

“…Our respondents revealed a number of areas with excellent compliance but also revealed areas where practice was mixed and somewhat outdated. An excellent example of compliance with international grade 1 evidence by a Cochrane review was in the use of absorbable synthetic suture material 24,25 . Our cohort of respondents were 100% compliant with current best practice using absorbable braided sutures for perineal repair.…”

“…A Cochrane meta‐analysis suggests that the preferred technique for repairing the vagina, perineal muscles, and skin is continuous nonlocking suturing. The evidence for this technique includes reduced short‐term pain, decreased need for analgesia, improved sexual function, fewer postnatal suture removals, and greater cost‐effectiveness 24,27,28 . 85.4% of our study participants used this continuous nonlocking technique at the level of the vaginal mucosa, and 80.9% used it (specifically a subcuticular version of this technique) for the skin.…”

Acute pain management after vaginal delivery with perineal tears or episiotomy

“…A meta-analysis published in 2010 included 18 RCTs comparing different suture materials for perineal repair after a vaginal delivery 86. Comparing standard synthetic with rapidly absorbing sutures, no difference in pain intensity was observed between the groups, but more women required suture removal in the standard synthetic suture group.…”

Optimizing and enhancing perineal repair knowledge and teaching among obstetricians and midwives: A prospective three‐site study

“…This may represent a delay in the filtration of up‐to‐date evidence into clinical settings, and may indeed result in trainees being taught by trainers who are practicing older and outdated techniques. Our teaching reinforced the up‐to‐date guidance from international collegiate bodies, as well as evidence supported by meta‐analyses 24,29,30,33 …”

“…Our teaching reinforced the up-to-date guidance from international collegiate bodies, as well as evidence supported by meta-analyses. 24,29,30,33 Our work also highlights that almost one in 10 practitioners were left-hand dominant. During our teaching intervention we noted that the majority of teaching tools available (videos, materials, and surgical instructions) were all targeted to a right-handed surgeon.…”

“…Our respondents revealed a number of areas with excellent compliance but also revealed areas where practice was mixed and somewhat outdated. An excellent example of compliance with international grade 1 evidence by a Cochrane review was in the use of absorbable synthetic suture material 24,25 . Our cohort of respondents were 100% compliant with current best practice using absorbable braided sutures for perineal repair.…”

“…A Cochrane meta‐analysis suggests that the preferred technique for repairing the vagina, perineal muscles, and skin is continuous nonlocking suturing. The evidence for this technique includes reduced short‐term pain, decreased need for analgesia, improved sexual function, fewer postnatal suture removals, and greater cost‐effectiveness 24,27,28 . 85.4% of our study participants used this continuous nonlocking technique at the level of the vaginal mucosa, and 80.9% used it (specifically a subcuticular version of this technique) for the skin.…”

Acute pain management after vaginal delivery with perineal tears or episiotomy

“…A meta-analysis published in 2010 included 18 RCTs comparing different suture materials for perineal repair after a vaginal delivery 86. Comparing standard synthetic with rapidly absorbing sutures, no difference in pain intensity was observed between the groups, but more women required suture removal in the standard synthetic suture group.…”