European journal of obstetrics, gynecology, and reproductive biology · 2025
Continuous versus interrupted suturing for second-degree perineal tears and episiotomies: A meta-analysis of randomized trials.
СтатьяМетаанализСравнительное исследованиеОбзорНазвание и аннотация: Перевод в очереди
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Defante Maria L R, de Souza Kevlin, Oliveira Juliana Almeida, Inoue Salgado Afonso Shiguemi, de Oliveira Flávia Ribeiro, Cardoso Fabrízio Dos Santos
Аннотация
INTRODUCTION: Perineal injuries during vaginal delivery, including second-degree lacerations and episiotomies, require effective suturing techniques. Despite being associated with decreased pain and improved short-term outcomes, continuous suturing has inconclusive results regarding long-term benefits.
OBJECTIVE: To assess the comparative efficacy and safety of continuous versus interrupted suturing for the repair of second-degree perineal tears and episiotomies.
METHODS: Data were analyzed using random-effects models to calculate pooled risk ratios (RR) with 95 % confidence intervals (CI). P values < 0.05 were considered statistically significant. Heterogeneity was assessed using Cochran's Q test and I2 statistics. Statistical analyses were conducted using R version 4.3.2.
RESULTS: Seventeen RCTs were included, encompassing a total of 5,851 postpartum women. Continuous suturing significantly reduced pain (RR 0.74; 95 % CI 0.65-0.83) and analgesia use (RR 0.81; 95 % CI 0.67-0.97) at 15 days postpartum, as well as wound dehiscence at 10 days (RR 0.64; 95 % CI 0.43-0.95). No significant differences were observed between techniques for pain, analgesia, dyspareunia, or sexual resumption at 3 months. The need for resuturing was also similar.
CONCLUSIONS: Continuous suturing offers clear short-term benefits without impacting longer-term sexual or pain outcomes. These findings support its preferential use for second-degree perineal repair, while highlighting the need for further research into patient-centered outcomes like dyspareunia and quality of life.
OBJECTIVE: To assess the comparative efficacy and safety of continuous versus interrupted suturing for the repair of second-degree perineal tears and episiotomies.
METHODS: Data were analyzed using random-effects models to calculate pooled risk ratios (RR) with 95 % confidence intervals (CI). P values < 0.05 were considered statistically significant. Heterogeneity was assessed using Cochran's Q test and I2 statistics. Statistical analyses were conducted using R version 4.3.2.
RESULTS: Seventeen RCTs were included, encompassing a total of 5,851 postpartum women. Continuous suturing significantly reduced pain (RR 0.74; 95 % CI 0.65-0.83) and analgesia use (RR 0.81; 95 % CI 0.67-0.97) at 15 days postpartum, as well as wound dehiscence at 10 days (RR 0.64; 95 % CI 0.43-0.95). No significant differences were observed between techniques for pain, analgesia, dyspareunia, or sexual resumption at 3 months. The need for resuturing was also similar.
CONCLUSIONS: Continuous suturing offers clear short-term benefits without impacting longer-term sexual or pain outcomes. These findings support its preferential use for second-degree perineal repair, while highlighting the need for further research into patient-centered outcomes like dyspareunia and quality of life.