DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20172042

Comparative study of episiotomy repair: absorbable synthetic versus chromic catgut suture material

Devika Perumal, Divya Selvaraju

Abstract


Background: The choice of suture material for repair of episiotomy or perineal laceration is largely of one’s personal preference. Chromic catgut was widely used in most institutions. It now appears that chromic catgut is associated with more postpartum discomfort and hence chromic catgut has been largely replaced by synthetic absorbable materials like polyglactin and polyglycolic acid.

Methods: The study was conducted in Institute of Social Obstetrics and Government Kasturba Gandhi Hospital, Chennai. This is a prospective, comparative study involving two groups. The use of a rapidly absorbing form of synthetic absorbable suture material, in the repair of episiotomy or perineal laceration in 100 patients during the study period February 2012 to July 2012, were simultaneously compared with the traditional natural absorbable suture material.

Results: With the use of rapidly absorbing polyglactin 910, there was a significant reduction (p=0.000) in the short-term pain, 19 compared to 80 in the control group. With regard to wound dehiscence and the need for resuturing, there was statistically significant difference in the control group (15%) compared to the study group (0%). There was no statistical significance between the two groups in terms of dyspareunia (12.4% vs 10.7%).

Conclusions: Fast-absorbing form of Polyglactin seems to be effective in reducing some of the morbidity associated with perineal repair following childbirth. There was significant reduction in the short-term pain and the need for analgesia. The incidence of wound dehiscence was markedly reduced.


Keywords


Episiotomy, Polygalactin, Vicryl rapide

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References


uhling KJ, Schimdt S, Robinson JN, Klapp C, Siebert G, Dudenhausen JW. Rate of dysparuenia after delivery in primiparae according to mode of delivery. Eur J Obstet Gynecol Reprod Biol. 2006;24:42-6.

Kettle C, Johanson RB. Absorbable synthetic versus catgut suture material for perineal repair. Cochrane Database Syst Rev. 2000:CD 000006.

Royal College of Obstetricians and Gynaecologists (RCOG). Method and materials used in perineal repair. London (UK): Royal College of Obstetricians and Gynaecologists (RCOG); 2004 Guidelines; No. 23.

Upton A, Roberts CL, Ryan M, Faulkner M, Reynolds M, Raynes Greenow C. A randomized trial conducted by midwives, of perineal repairs comparing a polyglycolic suture material and chromic catgut. Midwifery. 2002;18:223-9.

Kurian J, Bhaskaran S, Shivaram P. Comparative study of episiotomy repair: Absorbable synthetic versus chromic catgut suture material. J Obstet Gynecol India. 2008;58:495-9.

Masson F, Bilweis J, Di Lucca D, Trentesaux G, Wrobe N. Interest in a new suture material for 2000 episiotomy repairs: polyglactin 910. Clin Gynecol Obstet. 1988:19-21.

Mackrodt C, Gordon B, Fern E, Ayers S, Truesdale A, Grant A. The Ipswich Childbirth Study: 2. A randomised comparison of polyglactin 910 with chromic catgut for postpartum perineal repair. Br J Obstet Gynaecol. 1998;105:441-5.

Shah PK, Nickalse P, Gourewar V, Dholakia S. A randomized comparative study of polyglactin-910 vs chromic catgut for postpartum episiotomy repair: A pilot study. Obstet Gynaecol. 2001;6(8):465-8.

Greenberg JA, Lieberman E, Cohen AP, Ecker JL. Randomized comparison of chromic versus fast-absorbing polyglactin 910 for postpartum perineal repair. Obstet Gynecol. 2004;103:1308.

Kettle C, Dowswell T, Ismail KM. Absorbable suture materials for primary repair of episiotomy and second degree tears. Cochrane Database Syst Rev. 2010;CD000006.

McElhinney BR, Glenn DR, Dornan G, Harper MA (2000) Episiotomy repair: vicryl versus vicryl rapide. Ulster Med J. 69:27-9.