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The choice of suture materials and techniques for repair of perineal trauma: an overview of the evidence from controlled trials
Author(s) -
GRANT ADRIAN
Publication year - 1989
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1989.tb03225.x
Subject(s) - medicine , surgery , fibrous joint , childbirth , pregnancy , biology , genetics
Summary A systematic review of the 14 relevant controlled trials was conducted because there is no agreement about the choice of material and technique for repair of perineal trauma sustained during childbirth. Derivatives of polyglycolic acid (marketed as Dexon and Vicryl) appear to be the absorbable material of choice for both deep and skin closure. Compared with catgut their use is associated with about a 40% reduction in short‐term pain and need for analgesia. The main drawback is that some material often needs removal during the puerperium. Glycerol‐impregnated catgut is ruled out because of its link with longterm dyspareunia. Compared with the non‐absorbable materials (silk and nylon) polyglycolic acid skin sutures were associated with less shortterm perineal pain, and had no clear disadvantages. Continuous, subcuticular stitching appears preferable to interrupted, transcutaneous suturing, particularly in terms of perineal pain in the early puerperium.