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Episiotomy Closure After Vaginal Delivery – A Prospective, Single Centre Study Assessing a Novel Fast-Absorbable, Monofilament Suture in Daily Practice

Received: 8 April 2021    Accepted: 29 April 2021    Published: 26 May 2021
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Abstract

This is the first assessment on the performance of a new fast-absorbable monofilament suture for episiotomy closure under daily clinical routine. The study was designed as a prospective, single centre, observational study including 50 women. Satisfaction and pain using the visual analogue scale was rated at discharge and eight weeks post-partum. Handling characteristics of the suture were assessed intrasurgically by the obstretricians using a 5-point Likert scale. Adverse events and wound healing outcome was monitored for eight weeks after delivery. Perineal pain rate as well as the pain level in different categories strongly decreased from discharge to eight weeks post-partum. Patient satisfaction was high, 84.4±18.97 and 91.2±16.86 at discharge and eight weeks after delivery, respectively. In total, 50% of the women had sexual intercourse 10 weeks post-partum. Suture handling was rated good to excellent by the obstretricians. Wound healing assessment indicated an excellent outcome. No wound dehiscence, wound infection, tissue reaction, allergic or inflammatory reaction occurred. Neither need for resuturing of the wound nor intrasurgical suture rupture were reported. Findings indicate that the clinical performance of novel, fast-absorbable, monofilament suture is equivalent to current sutures used for episiotomy closure and can be regarded as a viable alternative to rapid, absorbable multifilaments.

Published in Journal of Surgery (Volume 9, Issue 3)
DOI 10.11648/j.js.20210903.15
Page(s) 121-127
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Episiotomy, Perineal Repair, Perineal Pain, Suture, Wound Healing, Patient Satisfaction

References
[1] Weber AM, Meyn L. Episiotomy us in the United States, 1979-1997. Obstet Gynaecol 2002; 100: 1177-82.
[2] De Leeuw JW, Kuijken JP, Bruinse HW. Mediolateral episiotomy reduces the risk for anal sphincter injury during surgical vaginal delivery. BJOG 2008, 115: 104-8.
[3] Christianes WNM, de Vries R. Trends in the medicalization of childbirth in Flanders and the NetherlandsMidwifery. 2013; 29: e1-8.
[4] Frohlich J, Kettle C. Perineal care. BMJ Clinical Evidence 2015; 03: 1401.
[5] Sleep J. Perineal care, a series of 5 randomized controlled trials. In: Robinson S, Thomson A (eds) Midwives research and childbirth. Chapman and Hall, London, pp 199-251.
[6] Kettle C, Johanson RB. Absorbable synthetic versus catgut suture material for perineal repair. Cochrane Database Syst Rev. 2000; (2): CD000006.
[7] Kettle C, Hills RK, Jones P, Darby L, Gray R, Johanson R. Continuous versus interrupted perineal repair with standard or rapidly absorbed sutures after spontaneous vaginal birth: a randomised controlled trial. Lancet. 2002; 359 (9325): 2217-23.
[8] Kettle C, Dowswell T, Ismail KM. Continuous and interrupted suturing techniques for repair of episiotomy or second-degree tears. Cochrane Database Syst Rev. 2012 Nov 14; 11: CD000947.
[9] Kebaili S, Trigui K, Louati D, Smawi M, Hlima S, Dammak A, Gassara H, Chaabane K, Amouri H. Continuous versus interrupted techniques for repair of mediolateral episiotomy: a prospective 6 months follow-up study. Androl Gynecol: Curr Res. 2013; 1: 4.
[10] Morano S, Mistrangelo E, Pastorino D, Lijoi D, Costantini S, Ragni N. A randomized comparison of suturing techniques for episiotomy and laceration repair after spontaneous vaginal birth. J Minim Invasive Gynecol. 2006; 13 (5): 457-62.
[11] Kettle C, Dowswell T, Ismail KM. Absorbable suture materials for primary repair of episiotomy and second degree tears. Cochrane Database Syst Rev. 2010 Jun 16; (6): CD000006.
[12] Odijk R, Hennipman B, Rousian M, Madani K, Dijksterhuis M, de Leeuw JW, van Hof A. The MOVE-trial: Monocryl® vs. Vicryl Rapide™ for skin repair in mediolateral episiotomies: a randomized controlled trial. BMC Pregnancy Childbirth. 2017 Oct 16; 17 (1): 355.
[13] Dandolu V, Chatwani A. Randomized comparison of chromic versus fast-absorbing polyglactin 910 for post-partum perineal repair. Obstet Gynecol. 2004 Nov; 104 (5 Pt 1): 1104.
[14] Bharathi A, Reddy DB, Kote GS. A prospective randomized comparative study of Vicryl Rapide versus chromic catgut for episiotomy repair. J Clin Diagn Res. 2013; 7 (2): 326-30.
[15] Kokanali, Ugur M, Kuntay Kokanalı M, Karayalcın R, Tonguc E. Continuous versus interrupted episiotomy repair with monofilament or multifilament absorbed suture materials: a randomised controlled trial. Arch Gynecol Obstet. 2011; 284 (2): 275-80.
[16] Leroux N, Bujold E. Impact of chromic catgut versus polyglactin 910 versus fast-absorbing polyglactin 910 sutures for perineal repair: a randomized, controlled trial Am J Obstet Gynecol. 2006; 194 (6): 1585-90.
[17] McElhinney BR, Glenn DR, Dornan G, Harper MA. Episiotomy repair: Vicryl versus Vicryl Rapide. Ulster Med J. 2000; 69 (1): 27-9.
[18] Greenberg JA, Lieberman E, Cohen AP, Ecker JL. Randomized comparison of chromic versus fast-absorbing polyglactin 910 for post-partum perineal repair. Obstet Gynecol. 2004; 103 (6): 1308-13.
[19] Valenzuela P, Saiz Puente MS, Valero JL, Azorín R, Ortega R, Guijarro R. Continuous versus interrupted sutures for repair of episiotomy or second-degree perineal tears: a randomised controlled trial. BJOG. 2009; 116 (3): 436-41.
[20] Wong T, Wak HL, Wong HK, Leung KY. Perineal repair with standard versus rapidly adsorbed sutures after vaginal birth: a randomized controlled trial. Hong Kong J Gynaecol Obstet Midwifery 2006; 6: 4-9.
[21] Dencker A, Lundgren I, Sporrong T. Suturing after childbirth--a randomised controlled study testing a new monofilament material. BJOG. 2006 Jan; 113 (1): 114-6.
Cite This Article
  • APA Style

    Petra Baumann, Michael Weigel. (2021). Episiotomy Closure After Vaginal Delivery – A Prospective, Single Centre Study Assessing a Novel Fast-Absorbable, Monofilament Suture in Daily Practice. Journal of Surgery, 9(3), 121-127. https://doi.org/10.11648/j.js.20210903.15

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    ACS Style

    Petra Baumann; Michael Weigel. Episiotomy Closure After Vaginal Delivery – A Prospective, Single Centre Study Assessing a Novel Fast-Absorbable, Monofilament Suture in Daily Practice. J. Surg. 2021, 9(3), 121-127. doi: 10.11648/j.js.20210903.15

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    AMA Style

    Petra Baumann, Michael Weigel. Episiotomy Closure After Vaginal Delivery – A Prospective, Single Centre Study Assessing a Novel Fast-Absorbable, Monofilament Suture in Daily Practice. J Surg. 2021;9(3):121-127. doi: 10.11648/j.js.20210903.15

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  • @article{10.11648/j.js.20210903.15,
      author = {Petra Baumann and Michael Weigel},
      title = {Episiotomy Closure After Vaginal Delivery – A Prospective, Single Centre Study Assessing a Novel Fast-Absorbable, Monofilament Suture in Daily Practice},
      journal = {Journal of Surgery},
      volume = {9},
      number = {3},
      pages = {121-127},
      doi = {10.11648/j.js.20210903.15},
      url = {https://doi.org/10.11648/j.js.20210903.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210903.15},
      abstract = {This is the first assessment on the performance of a new fast-absorbable monofilament suture for episiotomy closure under daily clinical routine. The study was designed as a prospective, single centre, observational study including 50 women. Satisfaction and pain using the visual analogue scale was rated at discharge and eight weeks post-partum. Handling characteristics of the suture were assessed intrasurgically by the obstretricians using a 5-point Likert scale. Adverse events and wound healing outcome was monitored for eight weeks after delivery. Perineal pain rate as well as the pain level in different categories strongly decreased from discharge to eight weeks post-partum. Patient satisfaction was high, 84.4±18.97 and 91.2±16.86 at discharge and eight weeks after delivery, respectively. In total, 50% of the women had sexual intercourse 10 weeks post-partum. Suture handling was rated good to excellent by the obstretricians. Wound healing assessment indicated an excellent outcome. No wound dehiscence, wound infection, tissue reaction, allergic or inflammatory reaction occurred. Neither need for resuturing of the wound nor intrasurgical suture rupture were reported. Findings indicate that the clinical performance of novel, fast-absorbable, monofilament suture is equivalent to current sutures used for episiotomy closure and can be regarded as a viable alternative to rapid, absorbable multifilaments.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Episiotomy Closure After Vaginal Delivery – A Prospective, Single Centre Study Assessing a Novel Fast-Absorbable, Monofilament Suture in Daily Practice
    AU  - Petra Baumann
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    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
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    UR  - https://doi.org/10.11648/j.js.20210903.15
    AB  - This is the first assessment on the performance of a new fast-absorbable monofilament suture for episiotomy closure under daily clinical routine. The study was designed as a prospective, single centre, observational study including 50 women. Satisfaction and pain using the visual analogue scale was rated at discharge and eight weeks post-partum. Handling characteristics of the suture were assessed intrasurgically by the obstretricians using a 5-point Likert scale. Adverse events and wound healing outcome was monitored for eight weeks after delivery. Perineal pain rate as well as the pain level in different categories strongly decreased from discharge to eight weeks post-partum. Patient satisfaction was high, 84.4±18.97 and 91.2±16.86 at discharge and eight weeks after delivery, respectively. In total, 50% of the women had sexual intercourse 10 weeks post-partum. Suture handling was rated good to excellent by the obstretricians. Wound healing assessment indicated an excellent outcome. No wound dehiscence, wound infection, tissue reaction, allergic or inflammatory reaction occurred. Neither need for resuturing of the wound nor intrasurgical suture rupture were reported. Findings indicate that the clinical performance of novel, fast-absorbable, monofilament suture is equivalent to current sutures used for episiotomy closure and can be regarded as a viable alternative to rapid, absorbable multifilaments.
    VL  - 9
    IS  - 3
    ER  - 

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Author Information
  • Department Medical Scientific Affairs, Aesculap, Tuttlingen, Germany

  • Department of Obstetrics & Gynaecology, Leopoldina Hospital, Schweinfurt, Germany

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