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Abstract
Introduction: We aimed to test the null hypothesis that there is no difference in patient pain among three different methods of perineal skin closure during second-degree repair: 1) suture, 2) no suture, and 3) surgical glue.
Methods: A single-blind randomized controlled trial of women post vaginal birth with a second-degree perineal laceration was conducted at a tertiary care teaching hospital August 2014 – April 2017.Following repair of the deep tissues per standard fashion, women were randomized to perineal skin closure with suture, no suture or surgical glue using a 1:1:1 allocation. Pain was assessed using the McGill, 100-mm VAS and Present Pain Index at 1 day, 2 weeks and 6 weeks postpartum.
Results: 35 women were randomized: 14 received suture, 11 no suture and 10 had surgical glue. Demographics were similar between groups. At 2 weeks, women with suture had higher pain scores than those with surgical glue or no suture (McGill: suture vs glue vs no suture, 16.2 ± 9.9 vs 6.4 ± 8.4 vs 4.7 ± 5.8, ANOVA p = .021; VAS: 50.6 ± 31.7 vs 17.7 ± 25.7 vs 10.9 ± 12.2, ANOVA p=.009). At 6 weeks, pain scores remained higher with suture versus glue (McGill, p = .045) and no suture (VAS, p = .047). No difference in pain was seen between women with glue vs no suture.
Conclusion/Implications: Compared to no suture and surgical glue, suturing the perineal skin was associated with the highest pain scores 6 postpartum weeks. Pain with surgical glue and no suture was similar.
Methods: A single-blind randomized controlled trial of women post vaginal birth with a second-degree perineal laceration was conducted at a tertiary care teaching hospital August 2014 – April 2017.Following repair of the deep tissues per standard fashion, women were randomized to perineal skin closure with suture, no suture or surgical glue using a 1:1:1 allocation. Pain was assessed using the McGill, 100-mm VAS and Present Pain Index at 1 day, 2 weeks and 6 weeks postpartum.
Results: 35 women were randomized: 14 received suture, 11 no suture and 10 had surgical glue. Demographics were similar between groups. At 2 weeks, women with suture had higher pain scores than those with surgical glue or no suture (McGill: suture vs glue vs no suture, 16.2 ± 9.9 vs 6.4 ± 8.4 vs 4.7 ± 5.8, ANOVA p = .021; VAS: 50.6 ± 31.7 vs 17.7 ± 25.7 vs 10.9 ± 12.2, ANOVA p=.009). At 6 weeks, pain scores remained higher with suture versus glue (McGill, p = .045) and no suture (VAS, p = .047). No difference in pain was seen between women with glue vs no suture.
Conclusion/Implications: Compared to no suture and surgical glue, suturing the perineal skin was associated with the highest pain scores 6 postpartum weeks. Pain with surgical glue and no suture was similar.
Introduction: We aimed to test the null hypothesis that there is no difference in patient pain among three different methods of perineal skin closure during second-degree repair: 1) suture, 2) no suture, and 3) surgical glue.
Methods: A single-blind randomized controlled trial of women post vaginal birth with a second-degree perineal laceration was conducted at a tertiary care teaching hospital August 2014 – April 2017.Following repair of the deep tissues per standard fashion, women were randomized to perineal skin closure with suture, no suture or surgical glue using a 1:1:1 allocation. Pain was assessed using the McGill, 100-mm VAS and Present Pain Index at 1 day, 2 weeks and 6 weeks postpartum.
Results: 35 women were randomized: 14 received suture, 11 no suture and 10 had surgical glue. Demographics were similar between groups. At 2 weeks, women with suture had higher pain scores than those with surgical glue or no suture (McGill: suture vs glue vs no suture, 16.2 ± 9.9 vs 6.4 ± 8.4 vs 4.7 ± 5.8, ANOVA p = .021; VAS: 50.6 ± 31.7 vs 17.7 ± 25.7 vs 10.9 ± 12.2, ANOVA p=.009). At 6 weeks, pain scores remained higher with suture versus glue (McGill, p = .045) and no suture (VAS, p = .047). No difference in pain was seen between women with glue vs no suture.
Conclusion/Implications: Compared to no suture and surgical glue, suturing the perineal skin was associated with the highest pain scores 6 postpartum weeks. Pain with surgical glue and no suture was similar.
Methods: A single-blind randomized controlled trial of women post vaginal birth with a second-degree perineal laceration was conducted at a tertiary care teaching hospital August 2014 – April 2017.Following repair of the deep tissues per standard fashion, women were randomized to perineal skin closure with suture, no suture or surgical glue using a 1:1:1 allocation. Pain was assessed using the McGill, 100-mm VAS and Present Pain Index at 1 day, 2 weeks and 6 weeks postpartum.
Results: 35 women were randomized: 14 received suture, 11 no suture and 10 had surgical glue. Demographics were similar between groups. At 2 weeks, women with suture had higher pain scores than those with surgical glue or no suture (McGill: suture vs glue vs no suture, 16.2 ± 9.9 vs 6.4 ± 8.4 vs 4.7 ± 5.8, ANOVA p = .021; VAS: 50.6 ± 31.7 vs 17.7 ± 25.7 vs 10.9 ± 12.2, ANOVA p=.009). At 6 weeks, pain scores remained higher with suture versus glue (McGill, p = .045) and no suture (VAS, p = .047). No difference in pain was seen between women with glue vs no suture.
Conclusion/Implications: Compared to no suture and surgical glue, suturing the perineal skin was associated with the highest pain scores 6 postpartum weeks. Pain with surgical glue and no suture was similar.
Randomized Trial Comparing Three Methods of Perineal Skin Closure at the Time of Second Degree Repair
Dr. Carolyn Swenson
Abstract
Introduction: We aimed to test the null hypothesis that there is no difference in patient pain among three different methods of perineal skin closure during second-degree repair: 1) suture, 2) no suture, and 3) surgical glue.
Methods: A single-blind randomized controlled trial of women post vaginal birth with a second-degree perineal laceration was conducted at a tertiary care teaching hospital August 2014 – April 2017.Following repair of the deep tissues per standard fashion, women were randomized to perineal skin closure with suture, no suture or surgical glue using a 1:1:1 allocation. Pain was assessed using the McGill, 100-mm VAS and Present Pain Index at 1 day, 2 weeks and 6 weeks postpartum.
Results: 35 women were randomized: 14 received suture, 11 no suture and 10 had surgical glue. Demographics were similar between groups. At 2 weeks, women with suture had higher pain scores than those with surgical glue or no suture (McGill: suture vs glue vs no suture, 16.2 ± 9.9 vs 6.4 ± 8.4 vs 4.7 ± 5.8, ANOVA p = .021; VAS: 50.6 ± 31.7 vs 17.7 ± 25.7 vs 10.9 ± 12.2, ANOVA p=.009). At 6 weeks, pain scores remained higher with suture versus glue (McGill, p = .045) and no suture (VAS, p = .047). No difference in pain was seen between women with glue vs no suture.
Conclusion/Implications: Compared to no suture and surgical glue, suturing the perineal skin was associated with the highest pain scores 6 postpartum weeks. Pain with surgical glue and no suture was similar.
Methods: A single-blind randomized controlled trial of women post vaginal birth with a second-degree perineal laceration was conducted at a tertiary care teaching hospital August 2014 – April 2017.Following repair of the deep tissues per standard fashion, women were randomized to perineal skin closure with suture, no suture or surgical glue using a 1:1:1 allocation. Pain was assessed using the McGill, 100-mm VAS and Present Pain Index at 1 day, 2 weeks and 6 weeks postpartum.
Results: 35 women were randomized: 14 received suture, 11 no suture and 10 had surgical glue. Demographics were similar between groups. At 2 weeks, women with suture had higher pain scores than those with surgical glue or no suture (McGill: suture vs glue vs no suture, 16.2 ± 9.9 vs 6.4 ± 8.4 vs 4.7 ± 5.8, ANOVA p = .021; VAS: 50.6 ± 31.7 vs 17.7 ± 25.7 vs 10.9 ± 12.2, ANOVA p=.009). At 6 weeks, pain scores remained higher with suture versus glue (McGill, p = .045) and no suture (VAS, p = .047). No difference in pain was seen between women with glue vs no suture.
Conclusion/Implications: Compared to no suture and surgical glue, suturing the perineal skin was associated with the highest pain scores 6 postpartum weeks. Pain with surgical glue and no suture was similar.
Introduction: We aimed to test the null hypothesis that there is no difference in patient pain among three different methods of perineal skin closure during second-degree repair: 1) suture, 2) no suture, and 3) surgical glue.
Methods: A single-blind randomized controlled trial of women post vaginal birth with a second-degree perineal laceration was conducted at a tertiary care teaching hospital August 2014 – April 2017.Following repair of the deep tissues per standard fashion, women were randomized to perineal skin closure with suture, no suture or surgical glue using a 1:1:1 allocation. Pain was assessed using the McGill, 100-mm VAS and Present Pain Index at 1 day, 2 weeks and 6 weeks postpartum.
Results: 35 women were randomized: 14 received suture, 11 no suture and 10 had surgical glue. Demographics were similar between groups. At 2 weeks, women with suture had higher pain scores than those with surgical glue or no suture (McGill: suture vs glue vs no suture, 16.2 ± 9.9 vs 6.4 ± 8.4 vs 4.7 ± 5.8, ANOVA p = .021; VAS: 50.6 ± 31.7 vs 17.7 ± 25.7 vs 10.9 ± 12.2, ANOVA p=.009). At 6 weeks, pain scores remained higher with suture versus glue (McGill, p = .045) and no suture (VAS, p = .047). No difference in pain was seen between women with glue vs no suture.
Conclusion/Implications: Compared to no suture and surgical glue, suturing the perineal skin was associated with the highest pain scores 6 postpartum weeks. Pain with surgical glue and no suture was similar.
Methods: A single-blind randomized controlled trial of women post vaginal birth with a second-degree perineal laceration was conducted at a tertiary care teaching hospital August 2014 – April 2017.Following repair of the deep tissues per standard fashion, women were randomized to perineal skin closure with suture, no suture or surgical glue using a 1:1:1 allocation. Pain was assessed using the McGill, 100-mm VAS and Present Pain Index at 1 day, 2 weeks and 6 weeks postpartum.
Results: 35 women were randomized: 14 received suture, 11 no suture and 10 had surgical glue. Demographics were similar between groups. At 2 weeks, women with suture had higher pain scores than those with surgical glue or no suture (McGill: suture vs glue vs no suture, 16.2 ± 9.9 vs 6.4 ± 8.4 vs 4.7 ± 5.8, ANOVA p = .021; VAS: 50.6 ± 31.7 vs 17.7 ± 25.7 vs 10.9 ± 12.2, ANOVA p=.009). At 6 weeks, pain scores remained higher with suture versus glue (McGill, p = .045) and no suture (VAS, p = .047). No difference in pain was seen between women with glue vs no suture.
Conclusion/Implications: Compared to no suture and surgical glue, suturing the perineal skin was associated with the highest pain scores 6 postpartum weeks. Pain with surgical glue and no suture was similar.
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