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Single-knot versus multiple-knot technique of perineal repair: a randomised controlled trial.

Abstract：

PURPOSE:An important factor influencing the outcome of perineal repair is the repair technique. This study was done to determine if there is a difference in post perineal repair pain scores following the use of the standard multiple-knot technique (MKT) of perineal repair and a single-knot technique (SKT). METHODS:We randomised 260 women who sustained a second-degree perineal tear at the University of Benin Teaching Hospital, Benin City, Nigeria and had perineal repair using either a SKT or a MKT between 1 July 2014 and 28 February 2015. Primary outcome measure was pain assessed with a numerical rating scale (0 = no pain, 10 = worst imaginable pain) on day two, day 10 and at 3 months. Secondary outcome measures were pain scores during basic activities of daily living, analgesia use, dyspareunia and patient satisfaction. RESULTS:Mean pain scores were significantly lower in the SKT group on day two (2.8 versus 5.6; P < 0.001) and day 10 (1.8 versus 3.3; P < 0.001). Significantly fewer women in the SKT group reported pain on day two (90/126, 71.4 % versus 122/128, 95.3 %; Relative Risk [RR] 0.6, 95 % Confidence Interval [CI] 0.6-0.8; P < 0.001), and day 10 (69/126, 54.8 % versus 107/128, 83.6 %; RR 0.7, 95 % CI 0.5-0.7; P < 0.001)]. Women in the SKT group were more likely to be satisfied with outcome of repair at three months (RR 1.4, 95 % CI 1.2-1.5; P < 0.001). No difference in pain scores and dyspareunia at 3 months. CONCLUSIONS:SKT of perineal repair is associated with significantly less pain in the first 10 days postdelivery and a higher patient satisfaction rate at 3 months.

journal_name

Arch Gynecol Obstet

journal_title

Archives of gynecology and obstetrics

authors

Selo-Ojeme DO,Okonkwo CA,Atuanya C,Ndukwu K

doi

10.1007/s00404-016-4101-2

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

945-952

issue

5

eissn

0932-0067

issn

1432-0711

pii

10.1007/s00404-016-4101-2

journal_volume

294

pub_type

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