Episiotomy closure comparing enbucrilate tissue adhesive with conventional sutures.
OBJECTIVE
The purpose of the study was to evaluate the use of enbucrilate tissue adhesive compared with subcuticular polyglycolic acid sutures in episiotomy wound closure.


METHODS
In a prospective controlled trial, two groups were studied after undergoing an episiotomy skin wound repair using either enbucrilate tissue adhesive (n=32) or a subcuticular polyglycolic acid suture (n=30). The variables measured included pain scores during selected activities in the first 5 postnatal days, the time taken to become pain free after childbirth and the time taken to resume pain free sexual intercourse. Suitable patients were invited by the midwives to participate in the trial. If they gave consent to the trial, the gynecologist was contacted. If available, he would perform a repair using enbucrilate tissue adhesive. If he was not available, one of the midwives would perform a repair using subcuticular polyglycolic acid sutures. In this group, 90% of the women were recruited and sutured by one midwife.


RESULTS
Patients treated with enbucrilate were found to have significantly less postnatal pain while walking, became pain free in a shorter period (mean=25 days vs. 18 days; P<0.01) and were able to resume pain-free intercourse sooner (mean=34 days vs. 52 days; P<0.001).


CONCLUSIONS
Tissue adhesives incorporate the qualities of an ideal skin-closure material. The results demonstrate their advantage over the current standard suture-based methods of repair in the perineum. The use of adhesives merits further evaluation.
Bowen
M L
ML
Department of Obstetrics and Gynaecology, Northampton General Hospital, Northampton, UK. mikebowen@quista.net
Selinger
M
M
D000293:Adolescent; D000328:Adult; D003672:Defecation / Q000502:physiology; D004659:Enbucrilate / Q000627:therapeutic use*; D004841:Episiotomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D010147:Pain Measurement; D010502:Perineum / Q000503:physiopathology / Q000601:surgery; D011100:Polyglycolic Acid / Q000627:therapeutic use*; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D013537:Sutures; D013997:Time Factors; D014014:Tissue Adhesives / Q000627:therapeutic use*; D014554:Urination / Q000502:physiology
D014014:Tissue Adhesives; D011100:Polyglycolic Acid; D004659:Enbucrilate