[Comparison of perineal repair techniques of continuous and standard interrupted suturing in normal vaginal delivery]

ABSTRACT

Post-delivery surgical repair of the perineal region is frequently associated with pain and discomfort. The surgical technique may play a role in the intensity of pain and the wound healing process. This study was conducted to compare the influence of applying standard continuous versus interrupted suturing on pain sensation and the frequency of wound infection following episiotomy. In a randomized double blind clinical trial, 148 healthy women with normal vaginal delivery and sustained episiotomy were studied in the Hajar hospital, Shahrekord. In one group, perineal muscles fascia and skin tissues were repaired with continuous non-locking sutures. Standard interrupted locking suturing was applied for the next group. Pain feeling and wound infection were evaluated at 2 hours, 10[th] and 40[th] days of post-delivery by Visual Analog Scale and the signs of discoloration of skin, edema, purulent discharge, and wound dehiscence, respectively. Data were analyzed by t-student, X2 and Mann-Whitney tests. Pain intensity, the amount of consumed suturing material and the allocated time were less in the cases with continuous suturing [P<0.001]. The mean of pain intensity was 2.66 +/- 2.5 versus 3.84 +/- 2.56 and 0.53 +/- 1.63 versus 0.6 +/- 1.04 at 10[th] and 40[th] days after delivery in continuous and standard interrupted suturing groups, respectively [P<0.05]. Signs of wound infection were observed only in 4 cases [12.5%], all of which belonged to the standard interrupted suturing group. There was a statistically significant inter-group difference in terms of the frequency of observed wound infection [P<0.05]. The pain intensity and the chance of wound infection is less in continuous suturing of episiotomy wounds. It also is a safer and more cost-effective method as it lowers the bedding time of the mother and needs for surgical material: