title: A multicentre evaluation of the two-layered repair of postpartum perineal trauma.
abstract: We set out to compare a policy of two-layered postpartum perineal repair leaving the skin unsutured with a policy of three-layered repair, which involved skin closure. Parturients who sustained a second-degree tear or an episiotomy in four Nigerian centers were randomised to have either a two-layered repair (417 women) or a three-layered repair (406 women). Fewer women in the two-layered group reported perineal pain at 48 hours (57% vs. 65%, relative risk [RR] 0.87, 95% confidence interval [CI] 0.78-0.97) and 14 days postpartum (22% vs. 28%, RR 0.77, CI 0.61-0.98). The two-layered repair was also associated with reduced risk of suture removal (6% vs. 10%, RR 0.62, CI 0.39-0.99), and less superficial dyspareunia at 3 months (6% vs. 12%, RR 0.52, CI 0.33-0.81). The rates of wound healing were similar between the two groups. Leaving the skin unsutured during postpartum perineal repair reduces perineal pain and dyspareunia.
authors.affiliation: Zonal General Hospital, Kwale, Nigeria. oborovo@yahoo.com
authors.forename: V O
authors.initials: VO
authors.lastname: Oboro
authors.forename: T O
authors.initials: TO
authors.lastname: Tabowei
authors.forename: O M
authors.initials: OM
authors.lastname: Loto
authors.forename: J O
authors.initials: JO
authors.lastname: Bosah
mesh_terms: D000328:Adult; D004841:Episiotomy; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000601:surgery*; D010502:Perineum / Q000293:injuries* / Q000601:surgery*; D011247:Pregnancy; D013536:Suture Techniques; D014945:Wound Healing