Continuous Versus Interrupted Sutures for Episiotomy Wound and Perineal Tear Repair

Abstract

This study was conducted to compare continuous suturing technique with
interrupted method for the procedure of Episiotomy and second degree perineal tear
following vaginal delivery. It was a comparative prospective study conducted in
department of Obstetrics & Gynecology of M.K.C.G. Medical college, Berhampur ,
Odisha, India, from November 2019 to November 2020. Patients were randomized into
two groups; One group (A) was repaired with continuous, non-locking sutures
involving the vaginal mucosa, perineal muscles and subcutaneous tissues for skin
following delivery. The other group (B) with the same match had continuous locking
sutures of vaginal mucosa, interrupted sutures in the perineal muscles and interrupted
transcutaneous sutures for skin. The sutures used were absorbable (chromic catgut) and
identical in both the groups. The participants were asked about pain in sitting position
and during movement, the use of analgesics on the 2nd, 10th day and 6weeks
postpartum. A total of 700 women underwent vaginal deliveries with episiotomies
and/or with second degree perineal tear. Less repair time (five minute - p=0.0001) was
noted in continuous technique group and suture material consumed was also less (1
suture RR 3.10, 95% CI: 2.63-3.65). The comparison of pain on the 2nd, 10th day
showed that continuous suture techniques compared with interrupted sutures for
perineal closure are associated with less pain for up to 10 days postpartum (RR 1.61,
95% CI: 1.39-1.87 for 2
nd day and RR-1.23, CI:1.15-1.33 for 10th day). There was no
difference between the severity of pain in long term period [6weeks postpartum]
[RR-1.0, CI: 0.98-1.03] in both the techniques. Repair with continuous suturing was
quicker and less suture material was used in comparison with interrupted suturing.
There was less pain in short term periodin continuous technique and no difference
between the severities of pain in long term period in both the techniques.