A comparative study of postpartum pain perception following continuous versus interrupted episiotomy repair in primigravidas / Amira Maher Ali Maher Elesawy ; Supervised Waleed Elkhayat , Ayman Raslan , Mohammed Nabil

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Background: Prompt repair of episiotomy tear should be done in delivery room to reduce blood loss and prevent infection. Adequate pain relief should be provided before suturing, Aim and objectives: The aim of the study was to evaluate the effects of repair of episiotomy by continuous and interrupted methods in primigravidas, Subjects and methods: This study included 250 women divided into two groups according to the suturing technique. Group A: The Episiotomy was repaired using the continuous knotless suturing technique (CKT) which involved placing the first stitch above the apex of vaginal trauma to secure any bleeding points that might not be visible. Vaginal wound,perineal muscles (deep and superficial), and skin were reapproximated by continuous technique without tension. Skin sutures were placed closely, fairly and deeply in the subcutaneous tissue; reversed back and finished with a terminal knot placed in the vagina beyond the hymeneal remnants. Group B: The Episiotomy was repaired using the interrupted suture (IT) which involved placing three layers of sutures. A continuous stitch to close the vaginal epithelium was commenced above the apex of the wound and finished at the level of the fourchette.Three or four interrupted sutures were done to reapproximate the deep and superficial perineal muscles, and interrupted transcutaneous technique was also performed to close the skin .2The threads used for stitching were identical in both groups", Results: We found that there was highly significant difference between the studied groups in the 1st 7 days and there was significant difference between the studied groups in (Day 8) and no significant difference between the studied groups in (day 9 and day 10) and there is no statistically significant difference between the studied groups as regard wound infection

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