title: Using adhesive glue to repair first degree perineal tears: a prospective randomized controlled trial.
abstract: Our objective was to evaluate the effectiveness of adhesive glue in repairing first degree perineal tears. We conducted a noninferiority prospective, randomized, controlled trial comparing adhesive glue with traditional suturing. Each case was evaluated immediately after birth and after the puerperium. The two-sample t-test and the Mann-Whitney nonparametric test were applied to compare quantitative variables between the treatment groups. The chi-squared test and Fisher's exact test were used to assess the association between qualitative variables. A total of 102 women participated, 28 in the suture arm and 74 in the adhesive glue arm. While cosmetic and functional results of adhesive glue use were not inferior to suturing, the use of adhesive glue was associated with a shorter procedure, less need for local anesthetic, less pain, and greater satisfaction. Our results suggest a novel approach for the repair of common postpartum first degree lacerations. The use of adhesive glue achieves cosmetic and functional results equal to traditional suturing and offers some immediate advantages for the patient. While further clinical trials are needed to validate our results, it is important to inform obstetrician of the possible use of adhesive glue in these very common clinical scenarios. This trial is registered with NCT00746707.
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel ; Department of Obstetrics and Gynecology, Trillium Health Partners, 2200 Eglinton Avenue W, Mississauga, ON, Canada L5M 2N1.
authors.forename: Tomer
authors.identifier: 0000-0003-3773-0018
authors.initials: T
authors.lastname: Feigenberg
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel.
authors.forename: Esther
authors.initials: E
authors.lastname: Maor-Sagie
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel.
authors.forename: Einat
authors.initials: E
authors.lastname: Zivi
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel.
authors.forename: Mushira
authors.initials: M
authors.lastname: Abu-Dia
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel.
authors.forename: Assaf
authors.initials: A
authors.lastname: Ben-Meir
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel.
authors.forename: Hen Y
authors.initials: HY
authors.lastname: Sela
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel.
authors.forename: Yossef
authors.initials: Y
authors.lastname: Ezra
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D003487:Cyanoacrylates / Q000627:therapeutic use*; D004659:Enbucrilate / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D022125:Lacerations / Q000175:diagnosis / Q000628:therapy*; D007744:Obstetric Labor Complications / Q000175:diagnosis / Q000628:therapy*; D010502:Perineum / Q000293:injuries* / Q000473:pathology; D011098:Polyglactin 910; D011247:Pregnancy; D011446:Prospective Studies; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D003487:Cyanoacrylates; D014014:Tissue Adhesives; D011098:Polyglactin 910; C100832:octyl 2-cyanoacrylate; D004659:Enbucrilate
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