Randomized comparison of chromic versus fast-absorbing polyglactin 910 for postpartum perineal repair.

Abstract

OBJECTIVE:

We conducted a randomized trial to evaluate the healing characteristics of chromic versus fast-absorbing polyglactin 910.

METHODS:

Laboring women were randomly assigned to chromic or fast-absorbing polyglactin for perineal repairs. Subjects were evaluated at 24-48 hours, 10-14 days, and 6-8 weeks to assess perineal and uterine pain, analgesic use, presence of residual suture, and wound dehiscence.

RESULTS:

Between April 2002 and January 2003, 1,361 subjects were randomly assigned. Two thirds of women in each group (459 fast-absorbing polyglactin and 449 chromic) required sutures for perineal repairs. Women were evaluated according to randomization assignment. Overall, 794 (87%) of subjects received the appropriate allocated suture to repair a perineal laceration (399 of 459, 86.9% fast-absorbing polyglactin 910; 395 of 449, 88% chromic catgut). At 24-48 hours, there was a statistically significant reduction in uterine cramping pain (25% versus 34%; P =.006) in subjects randomly assigned to fast-absorbing polyglactin. At 10-14 days, there were no statistically significant differences between the groups. At 6-8 weeks there was, again, a statistically significant reduction in uterine cramping pain (1% versus 4%; P =.017) and a statistically significant decrease in analgesic use (5% versus 10%; P =.048) in subjects randomly assigned to fast-absorbing polyglactin. Finally, at 6-8 weeks postpartum there was no difference in residual suture (2 of 175 versus 2 of 134; P =.802) or wound breakdowns (4 of 175 versus 3 of 134; P =.959) for fast-absorbing polyglactin 910 and chromic catgut, respectively.

CONCLUSION:

Our data suggest that fast-absorbing polyglactin 910 and chromic elicit similar postpartum perineal discomfort. In contrast to previous studies evaluating standard polyglactin, our trial demonstrated that fast-absorbing polyglactin rarely requires late removal and has a similar wound breakdown profile as compared with chromic.

LEVEL OF EVIDENCE:

I

• Authors: James A Greenberg, Ellice Lieberman, Amy P Cohen, Jeffrey L Ecker
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 103 Issue 6 Pg. 1308-13 (Jun 2004) ISSN: 0029-7844 [Print] United States
• PMID: 15172869 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Chromium
• Polyglactin 910

Topics

• Catgut
• Chromium
• Female
• Humans
• Pain, Postoperative (epidemiology)
• Perineum (surgery)
• Polyglactin 910
• Postpartum Period
• Pregnancy
• Sutures
• Wound Healing