Continuous versus Interrupted Suturing in Repair of Lateral and Mediolateral Episiotomy : A Randomized Controlled Trial

Abstract

Background: Episiotomy is the surgical enlargement of the posterior aspect of the vagina by an incision to the perineum during the last part of the second stage of labor. The incision is performed with scissors or scalpel and is lateral or mediolateral in location. Aim: This study aims to compare postoperative pain following repair of episiotomy between continuous or interrupted suturing technique. Methodology: In the second stage of labor, 260 pregnant women received a mediolateral and lateral episiotomy 130 each in Ain Shams University, Maternity Hospital were chosen to participate in the study after obtaining a verbal consent. They were randomly allocated into two groups A and B, randomization was done using opaque sealed envelopes. Group A: was repaired by interrupted suturing technique and include 130 pregnant women 65 with mediolateral and 65 with lateral episiotomies. Group B: was repaired by continuous suturing technique and include 130 pregnant women 65 with mediolateral and 65 with lateral episiotomies. Result: This study was carried out on (260) women who were randomly selected to receive a mediolateral or lateral episiotomy in the second stage of labor repaired by either continuous or interrupted suture technique. There was significant difference detected between continuous and interrupted groups as regard pain 6 hours after delivery and dyspareunia. We found that the interrupted group had higher VAS pain score and dyspareunia scale. Conclusion and Recommendations: The use of a continuous knotless technique for perineal repair is associated with less perineal pain at 6 hours, less need for analgesia, lower VAS scores, lower dyspareunia scale and less wound complication than interrupted sutures techniques. For that, the introduction of a continuous suturing policy would provide more comfortability, less analgesia, less perineal pain, less dyspareunia and less wound complications are needed for the interrupted method of repair.