Perineal repair of media-lateral episiotomies and 2nd degree tears by midwives: A randomised controlled trial comparing three suture techniques

López-Lapeyrere, Carolina; Muñoz, Montserrat Solís; Hernández-López, Ana Belén; Rodríguez-Barrientos, Ricardo; González-Rubio, Raquel; Tejeda-Esteban, Ana; Fernández-Cañadas, Aurora; Muriel-Miguel, Cristina; Hernández-Álvarez, Esther; Torre-Marco, Gema de la; Campo, Laura García-del; Pérez-García, María Francisca; Montes-Montes, María Jesús; Martínez-Diaz, Teresa; Martín-Madrigal, Mónica; Serna-Gómez, Noelia; Salvador-López, Rita; Flor-Picado, Susana de la

doi:10.1016/j.ijnurstu.2020.103553

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…Furthermore, women in the intervention group took fewer analgesics. These findings are in agreement with other studies which demonstrated that continuous suturing needed shorter time and less material compared to interrupted suturing technique ( 6 , 7 , 11 , 13 , 22 ). This is because in the interrupted suturing technique, the stitches are individually tied, which needs more threads and longer repair time ( 28 ).…”

Section: Discussionsupporting

confidence: 93%

“…Several factors such as the type of suture material used, the suturing technique, and the skill of the healthcare professional have the greatest impact on the after-birth complications associated with perineal pain and wound healing ( 22 ). The Royal College of Obstetricians and Gynecologists (RCOG) guidelines recommend the use of continuous subcuticular technique for perineal skin closure and a loose, continuous non-locking suturing technique for vaginal tissue and perineal muscle as it is associated with less short-term pain compared with the interrupted method.…”

Section: Discussionmentioning

confidence: 99%

“…Our results demonstrated that in addition to reducing perineal pain and promoting wound healing, continuous non-locking suturing required shorter time and less suturing material compared to interrupted suturing. These findings have particular implications for women and professionals since the reduced procedure time lowers the risk of infection, hemorrhage, and discomfort after birth, and the lower material costs will bring about considerable economic savings in the healthcare system ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

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Continuous non-locking vs. interrupted suturing techniques for the repair of episiotomy or second-degree perineal tears: A single-blind randomized controlled trial

et al. 2023

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ObjectivePerineal trauma is a serious and frequent problem after childbirth which is experienced by millions of women worldwide. The technique used for perineal repair may have an impact on pain and wound healing. The aim of the present study was to compare the continuous non-locking technique with interrupted suturing for the repair of episiotomy or second-degree perineal tears.MethodsA single-blind randomized-controlled trial was conducted from October 2021 to August 2022 in Sina Hospital, Ahvaz, Iran. Three hundred women were selected and randomly assigned into control and intervention groups using block randomization technique. The main outcomes included pain and wound healing that were assessed using visual analog scale (VAS), as well as redness, edema, ecchymosis/bruising, discharge, and approximation scale (REEDA). The secondary outcomes were the use of analgesics, duration of perineal repair, material used for suturing, pain during urination and defecation, and resumption of sexual intercourse. The participants were followed up on the first and seventh days and in the 6th week postpartum. Mann-Whitney, Chi-square, and Generalized Estimating Equations (GEE) model were used for data analysis.ResultsWound healing was significantly better in the continuous non-locking suture technique compared to the interrupted technique (β = −1.98; P > 0.0001). Women also experienced less pain in the continuous non-locking suture technique (β = −2.46; P > 0.0001). There was a reduction in the use of analgesics, the duration of perineal repair, and the material used for suturing in the continuous non-locking suturing technique as opposed to the interrupted method (P < 0.0001).The odds of pain during urination and defecation significantly reduced in women who underwent the continuous non-locking method (P < 0.001). Also, women in the continuous non-locking group resumed their sexual intercourse earlier (P < 0.0001).ConclusionThe findings of this study revealed that use of continuous non-locking technique for suturing was associated with reduced perineal pain and improved wound healing. Furthermore, it was associated with a shorter duration of perineal repair, less suture material used, and less need for analgesics compared with the interrupted method. There is, however, need for more studies to confirm the results of the present study.Iranian registry for randomized controlled trials (Ref. ID: IRCT20190415043283N1).

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Continuous non-locking vs. interrupted suturing techniques for the repair of episiotomy or second-degree perineal tears: A single-blind randomized controlled trial

et al. 2023

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“…birçok değişkenin ağrı düzeyini etkilemesinden kaynaklanabileceği düşünülmüştür (48,49). Yapılan çalışmalarda, subkutan sürekli dikiş kullanımının ve ebelerin ya da dikişi yapan hekimin yüksek düzeydeki beceri ve uzmanlığının, epizyotomi sonrası ağrı şiddetini azalttığı bildirilmiştir (50,51). Araştırmamızın yapıldığı hastanede subkutan sürekli dikiş tekniğinin kullanılmasının, çalışmamıza katılan hastaların epizyotomi insizyonunda hissettikleri ağrı şiddetinin azalmasında etkili olan faktörlerden biri olabileceği düşünülmektedir.…”

Section: İnsizyon Ağrı Değerlendirmesine İlişkin Bulguların Tartışı...unclassified

EVALUATION of WOUND HEALING in EPISIOTOMY and CESAREAN INCISIONS USING REEDA SCALE

İLHAN

2022

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Some factors that prevent wound healing delay healing. Therefore, evaluation and monitoring of wounds is an important intervention. The use of scales in wound assessment is one of the factors that facilitate nursing care and increase the visibility of nursing functions. This descriptive and comparative study was conducted to evaluate wound healing in episiotomy and cesarean section incisions with the REEDA (Redness, Edema, Ecchymossıs, Discharge, Approximation) scale. The population of the study consisted of patients hospitalized in the gynecology and obstetrics clinic of a university hospital between 20.06.2019 and 02.08.2019, and the sample consisted of a total of 107 women, 53 of whom had a vaginal delivery with episiotomy and 54 who had a cesarean section. Research data were collected using the Patient and Wound Diagnosis Form, the REEDA Scale, and the Numerical Rating Scale. Statistical evaluation of the data was done using IBM SPSS 22 program and R programming language. On the 1st follow-up day of the study, it was determined that the REEDA scale total scores were higher in the episiotomy group and the difference was statistically significant (p<0.05). It was observed that the total scores of the scale did not create a significant difference between the groups on the 3rd and 7th follow-up days (p>0.05). In episiotomy incisions, the sub-subscale scores of the scale were higher on all follow-up days for redness, on the 1st and 3rd follow-up days for edema, and on the 1st follow-up day for discharge (p<0.05). The sub-subscale scores in cesarean section incisions were found to be higher and statistically significant on the 3rd and 7th follow-up days for ecchymosis and on the 7th follow-up day for discharge and approximation (p<0.05). According to REEDA scale scores, it was determined that the healing process in cesarean section wounds was longer than in episiotomy incision wounds.

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Repair of episiotomy and obstetrical perineal lacerations (first–fourth)

Schmidt

Fenner

2024

American Journal of Obstetrics and Gynecology

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Perineal repair of media-lateral episiotomies and 2nd degree tears by midwives: A randomised controlled trial comparing three suture techniques

Cited by 4 publications

References 18 publications

Continuous non-locking vs. interrupted suturing techniques for the repair of episiotomy or second-degree perineal tears: A single-blind randomized controlled trial

Continuous non-locking vs. interrupted suturing techniques for the repair of episiotomy or second-degree perineal tears: A single-blind randomized controlled trial

EVALUATION of WOUND HEALING in EPISIOTOMY and CESAREAN INCISIONS USING REEDA SCALE

Repair of episiotomy and obstetrical perineal lacerations (first–fourth)

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