Abstract

Objective: To compare the outcome of continuous versus interrupted suturing technique in association with postpartum perineal pain.
Study Design: Randomized clinical Trial.
Place & Duration of study: The Department of Obstetrics and Gynaecology, DHQH, Rwp. over a period of two months, from Aug. 2011 to Sept. 2011.
Methodology: All the patients with singleton Term pregnancy in occipito anterior position and delivered by spontaneous vertex delivery, who had been subjected to an episiotomy or perineal tearing affecting skin and muscles, were included in this study. Chromic catgut was used to stitch episiotomy. The postpartum pain was quantified from 0 to 10, using Joan Barron’s comparative pain scale, 2002. The patients were grouped into four categories, no pain (0), mild pain (1–3), moderate pain (4-6) and severe pain (7–10). The patients were assessed for pain on 1st and then on 3rd postnatal day by the Barron’s comparative verbal pain scale.
Results: One hundred and sixteen patients were included in the study. The patients were divided into two groups A and B. Group A (n=58) had continuous suturing by non locking sutures in the vagina, perineal muscles and subcutaneous tissue and group B (n=58) had interrupted perineal repair.  On the first postnatal day 59% (n=34) had no pain in group A compared with group B where only 38% (n=22) had no pain. Moderate pain was experienced by 21% cases (n=12) in group B, while no patient experienced moderate pain in group A. On 3rd postnatal day no patient experienced any perineal pain in group A while 22% (n=13) had mild pain and 10.3% (n=6) experienced moderate perineal pain in group B. On third postnatal day pain was significantly less among the patients with continuous suturing (p<0.001) as compared to interrupted suturing technique (p<0.06).
Conclusion: The continuous suture technique is found to be more effective suturing technique because patients experience less postnatal perineal pain as compared to interrupted technique.
Key words: Perineal repair, suturing technique, postnatal perineal pain.