A prospective randomized comparative study of vicryl rapide versus chromic catgut for episiotomy repair

BACKGROUND AND OBJECTIVES

A significant number of women experience perineal trauma following vaginal deliveries and they require stitches. This may result in perineal pain, dyspareunia and faulty healing. The type of suture material which is used, will influence these factors. This study was conducted to compare the impact of two absorbable suture materials which were used for episiotomy repair, namely vicryl rapide and chromic catgut in relation to a short term maternal morbidity, in terms of the perineal pain and the wound healing.

METHODS

This was a prospective, randomized study which was conducted in the hospitals which were attached to JJMMC, Davangere. Four hundred women with episiotomies were randomly allocated to repair with either vicrylrapide or chromic catgut (200 each). The outcome measures which were assessed were perineal pain and wound healing at 24-48 hours, 3-5 days and 6 weeks postpartum.

RESULTS

The two groups were similar at the trial entry. As compared to the chromic catgut group, the vicryl rapide group was associated with less pain (32.5% vs 57%) and a less need for analgesia (15.5% vs 0.5) at 3-5 days. There was also a signifi- cant reduction in the wound indurations, uncomfortable stitches and wound dehiscence (4% vs 13.5%) and a better wound healing (p<0.05 significant) in the vicrylrapide group. No significant difference was noted in the perineal pain at 6 weeks postpartum. Wound infections (3.5%) and wound resuturing (2%) were seen in the chromic catgut group and they were absent in the vicrylrapide group.

INTERPRETATION AND CONCLUSION

So, this study concluded that vicrylrapide was the ideal suture material for episiotomy repair, which resulted in less perineal pain and a better wound healing.

Premature Rupture of Membranes at Term: Immediate Induction With PGE(2) Gel Compared With Delayed Induction With Oxytocin

OBJECTIVES

To compare the effectiveness, safety of immediate induction with PGE(2) gel and expectant management in terms of maternal and fetal outcome in term PROM.

METHODS

100 women were randomized to group A, immediate induction and group B expectant management.

RESULTS

Spontaneous vaginal deliveries were more in group B. CS and operative vaginal deliveries were more in group A.

CONCLUSION

Expectant management followed by delayed induction with oxytocin is better than immediate induction with PGE(2) gel in term PROM. A good number of women go into spontaneous labor and deliver vaginally with out increase in the Cesarean section rate and infectious morbidity for mother and fetus.