A comparison of chromic catgut, polyglactin 910, and Vicryil rapide sutures for episiotomy repair: a randomized clinical trial

Abstract Background: Episiotomy is one of the common surgical procedures in maternity wards. A large number of women who undergo episiotomy suffer from short-term postpartum complications, which are associated with a type of applied suture. Chromic catgut, polyglactin 910 (Coated Vicryl) and Vicryil rapide are the most common suture materials for the perineal repair. The aim of this study is to compare three suture materials on perineal pain, infection, and inflammation at the site of perineal repair of episiotomy. Methods: This randomized clinical trial was conducted on 114 patients referred to the labor ward of Besat Hospital, Sanandaj City, Iran in 2017-2018. Random allocation was conducted using envelopes containing a number from one to three for the three suture materials. Each envelope was opened by the gynecology resident and each group was treated by a specific suture material. The severity of perineal pain, infection, incidence rate of inflammation, and residual materials were evaluated at the 48th hours, 7th day, and 42nd day and in the case of pain during sexual intercourse at the 6th week after episiotomy.Results: The severity of perineal pain was significantly different between the three groups at 48th hour, 7th day, and 42nd day after episiotomy (P<0.001). Moreover, 15.4% of the patients (n=6) who used Vicryil rapide suture reported no pain (P<0.001). Moreover, the severity of the moderate and severe pains at the 7th day and 42nd day were significantly lower in Vicryil rapide group in comparison with the chromic catgut and polyglactin 910 groups. The inflammation at the site of perineum repair was also significantly lower in the Vicryil rapide group in comparison with other two other groups at the 48th hour and 7th day after episiotomy (P<0.001). Furthermore, the pain severity during sexual intercourse was significantly lower in the Vicryil rapide group (P<0.001). Conclusions: According to the results, using Vicryil rapide suture for episiotomy repair was associated with earlier pain and inflammation reduction at the site of perineum repair.Trial registration: IRCT20141208020249N5 (http://en.irct.ir/trial/34194)Date trial registration: 02 February 2019 (The trial was retrospectively registered)