Perineal Repair with Standard versus Rapidly Absorbed Sutures after Vaginal Birth: a Randomised Controlled Trial

Abstract

Objective: The aim of this randomised controlled trial was to test whether rapidly absorbed polyglactin suture can reduce visible stitches rate.
Materials and Methods: From January 2002 to December 2002, all women having vaginal birth in Queen Elizabeth Hospital who needed episiotomy repair were asked to join the study. The repairing procedure was a three-layered technique. Vaginal and perineal muscle was repaired by chromic catgut separately. Subcuticular layer was repaired either by standard polyglactin 910 or rapidly absorbed polyglactin 910 suture. All women were then randomly allocated to these two different suture materials. They were later contacted by telephone on day 5, 2 weeks, and 3 months after delivery to evaluate visible stitches rate, removal of stitches, insufficient healing and/or resuturing and perineal pain perception.
Results: Five hundred and ten women, including 468 spontaneous vaginal delivery and 42 ventouse delivery, were recruited with written consent. Two hundred and forty-two women of spontaneous vaginal delivery and 19 of ventouse delivery were repaired by standard polyglactin 910 material. Remaining women, including 226 spontaneous vaginal delivery and 23 ventouse delivery, used rapidly absorbed polyglactin 910 suture. Within 3 months, women sutured with standard polyglactin 910 had significantly more visible stitches rate of 38 (14.9%) versus 19 (8.0%) cases when compared to rapidly absorbed polyglactin 910. The difference in visible stitches rate became significant starting from 2 weeks after delivery.
Conclusion: The use of rapidly absorbed polyglactin in continuous subcuticular perineal repair can significantly reduce the occurrence of visible stitches.