A comparative study of absorbable synthetic versus chromic catgut suture in the repair of episiotomy
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 11
Abstract
Introduction: An episiotomy, also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall generally done by a midwife or obstetrician during second stage of labor to quickly enlarge the opening for the baby to pass through. The incision, which can be done at a 90 degree angle from the vulva towards the anus or at an angle from the posterior end of the vulva (medio-lateral episiotomy), is performed under local anesthetic (pudendal anesthesia), and is sutured closed after delivery. Aims and Objective: To study the effectiveness of Absorbable Synthetic versus Chromic Catgut Suture in the Repair of Episiotomy. Methodology: This was clinical trial carried out at tertiary health care Centre during one year period from January 2014 to January 2015 in Obstetric patients who has indication of episiotomy for the Labor during one year period. Detailed history of the patients with type Local anesthesia Given, Surgical procedure, Time required for suturing, Average and Duration of the post-operative pain received by the patients were also noted, Average days required for healing, Infection Rate etc. were noted. The patient’s after their consent were randomly allocated into the Two groups i.e. Group I- Synthetic suture group (Polyglactin 910 (PG) is a synthetic absorbable suture material composed of a copolymer) and Group II- Chromic Catgut Suture. Statistical analysis was done by Graph pad prism for Calculation of Chi-square test, Un-paired t –test, Z-test (Standard error of difference between two proportions). Result: Average Severe pain experienced by patients was more in Synthetic group i.e.20 (63%) than Chromic Catgut Suture i.e. 12(37%) similarly Mild and Moderate Pain was more in synthetic group i.e. 21 (52%) and 19(48%) & 24(62%) and 14(38%) respectively but this observed difference was not statistically significant(X2 = 1.13, df=2,p>0.05,Not Significant). Average Duration of the Post- Partum Pain Experienced By the Patients of Longest duration was found to be in Chromic Catgut Suture i.e. up to 10th Post-Partum (PP) period was in10(76.93%) and in Synthetic suture group was in3 (23.07%) similarly up to 7th day was 25(55.56%) and 20(44.44%) & up to 5th day was 10 42(80.76%) and (10.24%) respectively, this observed difference was highly significant (X2 =21.07,df=2,p<0.0001,*HS-Highly Significant). Quantity of the (Local Anesthesia) LA required significantly higher in the Chromic Catgut Suture group as compared to Synthetic suture i.e. 7.58±0.9ml and 6.45±0.8ml (P<0.0001, t=6.919, df=108) but the time required for the suturing was significantly higher in the Synthetic suture group as compared to Chromic Catgut Suture group i.e. 18.4±2.2min and 14.7±2.1min (P<0.0001,t=8.83,df=108). Rate of Wound infection was significantly higher in the Chromic Catgut Suture as compared to Synthetic suture group 20% (9/45) and 7.69% (5/65) (P<0.05,Z=1904). Time required for the suture healing was significantly higher in the Chromic Catgut Suture group than Synthetic suture group 8±2days and 11±1.1days respectively (P<0.0001,t=9.142,df=108). Conclusion: Absorbable Synthetic suture material were superior to Chromic Catgut in terms of Average Duration of the Post- Partum Pain Experienced By the Patients, Quantity of the (Local Anesthesia) LA required, Rate of Wound infection, Time required for the suture healing but Chromic catgut were superior to Synthetic material in terms of time required for suturing so all these things should considered while using suture material for the episiotomy.
Authors and Affiliations
Swati Nagapurkar
Keywords
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