Comparative Study on Continuous Versus Interrupted Suturing of Episiotomy
DOI:
https://doi.org/10.55489/ijmr.120420245Keywords:
Episiotomy, Continuous suturing, Interrupted suturing, Wound healing, Maternal outcomesAbstract
Introduction: Episiotomy is a frequent obstetric intervention during vaginal delivery, necessitating effective repair techniques to minimize complications and enhance recovery. Continuous and interrupted suturing techniques are widely used, but their comparative efficacy remains debated. This study evaluates the impact of these techniques on wound healing, pain, complications, and patient satisfaction.
Method: A prospective comparative study was conducted over two years at Saraswathi Institute of Medical Sciences, Hapur, involving 200 women undergoing mediolateral episiotomy during vaginal delivery. Participants were randomized into continuous (n=100) and interrupted (n=100) suturing groups. Pain was assessed using the Visual Analogue Scale (VAS), and outcomes such as wound healing, complications, and cosmetic satisfaction were evaluated at 48 hours, one week, six weeks, and three months. Statistical analysis included Chi-square and t-tests.
Results: Continuous suturing required significantly less analgesia at 2 hours (28% vs. 85%, p < 0.001) and 48 hours (17% vs. 32%, p = 0.01). Pain scores in lying, sitting, and walking positions were consistently lower at 2 hours in the continuous group (p < 0.05). Continuous suturing also resulted in fewer cases of edema at 2 hours (4.0% vs. 14.0%, p = 0.013) and 48 hours (2.0% vs. 10.0%, p = 0.017). Wound dehiscence was significantly less frequent in the continuous group at 1 week (1.0% vs. 14.0%, p = 0.001).
Conclusion: Continuous suturing offers superior outcomes in reducing early pain, edema, and wound dehiscence compared to interrupted suturing, making it a preferred technique for episiotomy repair.
References
1. Carroli G, Mignini L. Episiotomy for vaginal birth. Cochrane Database Syst Rev 2009:CD000081. DOI: https://doi.org/10.1002/14651858.CD000081.pub2
2. Choudhari RG, Tayade SA, Venurkar S V, Deshpande VP. A Review of Episiotomy and Modalities for Relief of Episiotomy Pain. Cureus 2022;14. DOI: https://doi.org/10.7759/cureus.31620
3. Gurusamy KS, Toon CD, Allen VB, Davidson BR. Continuous versus interrupted skin sutures for non-obstetric surgery. Cochrane Database Syst Rev 2014;2014. DOI: https://doi.org/10.1002/14651858 PMid:38812899 PMCid:PMC7616025
4. Kettle C, Dowswell T, Ismail KM. Continuous and interrupted suturing techniques for repair of episiotomy or second‐degree tears. Cochrane Database Syst Rev 2012;2012. DOI: https://doi.org/10.1002/14651858 PMid:38812899 PMCid:PMC7616025
5. Scalise A, Calamita R, Tartaglione C, Pierangeli M, Bolletta E, Gioacchini M, et al. Improving wound healing and preventing surgical site complications of closed surgical incisions: a possible role of Incisional Negative Pressure Wound Therapy. A systematic review of the literature. Int Wound J 2016;13:1260. DOI: https://doi.org/10.1111/iwj.12492 PMid:26424609 PMCid:PMC7950088
6. Aydın Besen M, Rathfisch G. The effect of suture techniques used in repair of episiotomy and perineal tear on perineal pain and dyspareunia. Health Care Women Int 2020;41:22-37. DOI: https://doi.org/10.1080/07399332.2019.1663194 PMid:31509091
7. Fanshawe AM, De Jonge A, Ginter N, Takács L, Dahlen HG, Swertz MA, et al. The Impact of Mode of Birth, and Episiotomy, on Postpartum Sexual Function in the Medium- and Longer-Term: An Integrative Systematic Review. Int J Environ Res Public Health 2023;20. DOI: https://doi.org/10.3390/ijerph20075252 PMid:37047868 PMCid:PMC10094321
8. Myers-Helfgott MG, Helfgott AW. Routine use of episiotomy in modern obstetrics. Should it be performed? Obstet Gynecol Clin North Am 1999;26:305-25. DOI: https://doi.org/10.1016/S0889-8545(05)70077-2 PMid:10399764
9. Kettle C, Hills RK, Ismail KMK. Continuous versus interrupted sutures for repair of episiotomy or second degree tears. Cochrane Database Syst Rev 2007. DOI: https://doi.org/10.1002/14651858.CD000947.pub2
10. Rahul K, Bhoomika J, Sabrina M, Sushil K. Comparative study of continuous method and interrupted method of episiotomy in terms of healing of the surgical wound. Clinical Journal of Obstetrics and Gynecology 2021;4:040-3. DOI: https://doi.org/10.29328/journal.cjog.1001084
11. Samal SK, Rathod S. Comparative analysis of continuous and interrupted suturing techniques for repair of episiotomy or second degree perineal tear. Int J Reprod Contraception, Obstet Gynecol. 2017; 6: 1002 n.d. DOI: https://doi.org/10.18203/2320-1770.ijrcog20170573
12. Martínez-Galiano JM, Arredondo-López B, Molina-Garcia L, Cámara-Jurado AM, Cocera-Ruiz E, Rodríguez-Delgado M. Continuous versus discontinuous suture in perineal injuries produced during delivery in primiparous women: a randomized controlled trial. BMC Pregnancy Childbirth 2019;19. DOI: https://doi.org/10.1186/s12884-019-2655-2 PMid:31842788 PMCid:PMC6916034
13. Jena L, Kanungo S. A Comparative Study of Continuous Versus Interrupted Suturing for Repair of Episiotomy or Second Degree Perineal Tear. Int J Reprod Contracept Obstet Gynecol 2015:1. DOI: https://doi.org/10.5455/2320-1770.ijrcog20150210
14. Soliman LE, Ghareeb MA, Abd Elhameid AAE, Lashin ME-B. Interrupted versus continuous suturing of episiotomy : a comparative study. Zagazig University Medical Journal 2020;26:287-96.
15. Faal Siahkal S, Abedi P, Iravani M, Esfandiarinezhad P, Dastoorpoor M, Bakhtiari S, et al. Continuous non-locking vs. interrupted suturing techniques for the repair of episiotomy or second-degree perineal tears: A single-blind randomized controlled trial. Front Surg 2023;10:1114477. DOI: https://doi.org/10.3389/fsurg.2023.1114477 PMid:37091272 PMCid:PMC10113503
16. Perveen F, Pak TS-JS, 2009 undefined. Perineal repair: comparison of suture materials and suturing techniques. OldJspOrgPkF Perveen, T ShabbirJ Surg Pak, 2009•oldJspOrgPk n.d.
17. Hasanpoor S, Bani S, Shahgole R, Gojazadeh M. The Effects of Continuous and Interrupted Episiotomy Repair on Pain Severity and Rate of Perineal Repair: A Controlled Randomized Clinical Trial. J Caring Sci 2012;1:165.
Downloads
Published
How to Cite
Issue
Section
License
The authors retain the copyright of their article, with first publication rights granted to Medsci Publications.

