This is not the most recent version of the article. View current version (16 JUN 2010)
Intervention Review
Absorbable synthetic versus catgut suture material for perineal repair
Editorial Group: Cochrane Pregnancy and Childbirth Group
Published Online: 8 OCT 2008
Assessed as up-to-date: 30 JUN 1999
DOI: 10.1002/14651858.CD000006
Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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- Published Online: 8 OCT 2008
This is not the most recent version of the article.View current version (16 Jun 2010)
Abstract
Background
Approximately 70% of women will experience some degree of perineal trauma following vaginal delivery and will require stitches. This may result in perineal pain and superficial dyspareunia.
Objectives
The objective of this review was to assess the effects of absorbable synthetic suture material as compared with catgut on the amount of short and long term pain experienced by mothers following perineal repair.
Search strategy
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register.
Selection criteria
Randomised trials comparing absorbable synthetic (polyglycolic acid and polyglactin) with plain or chromic catgut suture for perineal repair in mothers after vaginal delivery.
Data collection and analysis
Trial quality was assessed independently by two reviewers. Data were extracted by one reviewer and checked by the second reviewer.
Main results
Eight trials were included. Compared with catgut, the polyglycolic acid and polyglactin groups were associated with less pain in first three days (odds ratio 0.62, 95% confidence interval 0.54 to 0.71). There was also less need for analgesia (odds ratio 0.63, 95% confidence interval 0.52 to 0.77) and less suture dehiscence (odds ratio 0.45, 95% confidence interval 0.29 to 0.70). There was no significant difference in long term pain (odds ratio 0.81, 95% confidence interval 0.61 to 1.08). Removal of suture material was significantly more common in the polyglycolic acid and polyglactin groups (odds ratio 2.01, 95% confidence interval 1.56 to 2.58). There was no difference in the amount of dyspareunia experienced by women.
Authors' conclusions
Absorbable synthetic suture material (in the form of polyglycolic acid and polyglactin sutures) for perineal repair following childbirth appears to decrease women's experience of short-term pain. The length of time taken for the synthetic material to be absorbed is of concern. A trial addressing the use of polyglactin has recently been completed and this has been included in this updated review.