The Experts below are selected from a list of 180 Experts worldwide ranked by ideXlab platform
Richard Johanson - One of the best experts on this subject based on the ideXlab platform.
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selected cochrane systematic reviews absorbable synthetic versus Catgut Suture material for perineal repair
Birth-issues in Perinatal Care, 2000Co-Authors: Christine Kettle, Richard JohansonAbstract:A substantive amendment to this systematic review was last made on 19 May 1999. Cochrane reviews are regularly checked and updated if necessary. ABSTRACT Background and objectives: Approximately 70% of women will experience some degree of perineal trauma following vaginal delivery and will require stitches. This may result in perineal pain and superficial dyspareunia. The objective of this review was to assess the effects of absorbable synthetic Suture material as compared with Catgut on the amount of short- and long-term pain experienced by mothers following perineal repair. Search strategy: We searched the Cochrane Pregnancy and Childbirth Group trials register. Selection criteria: Randomised trials comparing absorbable synthetic (polyglycolic acid and polyglactin) with plain or chromic Catgut Suture for perineal repair in mothers after vaginal delivery. Data collection and analysis: Trial quality was assessed independently by two reviewers. Data were extracted by one reviewer and checked by the second reviewer. Main results: Eight trials were included. Compared with Catgut, the polyglycolic acid and polyglactin groups were associated with less pain in first three days (odds ratio 0.62, 95% confidence interval 0.54–0.71). There was also less need for analgesia (odds ratio 0,63, 95% confidence interval 0.52–0.77) and less Suture dehiscence (odds ratio 0.45, 95% confidence interval 0.29–0.70). There was no significant difference in long-term pain (odds ratio 0.81, 95% confidence interval 0.61–1.08). Removal of Suture material was significantly more common in the polyglycolic acid and polyglactin groups (odds ratio 2.01, 95% confidence interval 1.56–2.58). There was no difference in the amount of dyspareunia experienced by women. Reviewers' conclusions: Absorbable synthetic Suture material (in the form of polyglycolic acid and polyglactin Sutures) for perineal repair following childbirth appears to decrease women's experience of short-term pain. The length of time taken for the synthetic material to be absorbed is of concern. A trial addressing the use of polyglactin has recently been completed and this has been included in this updated review. Citation: Kettle C, Johanson RB. Absorbable synthetic versus Catgut Suture material for perineal repair (Cochrane Review). In: The Cochrane Library, Issue 4, 1999, Oxford: Update Software. ••• The preceding report is an abstract of regularly updated, systematic reviews prepared and maintained by the Cochrane Collaboration. The full texts of the reviews are available in The Cochrane Library (ISSN 1464-780X). Seehttp://www.update-software.com/cochrane.htmor contact Update Software,info@update.co.uk, for information on subscribing to The Cochrane Library in your area. Update Software Ltd, Summertown Pavilion, Middle Way, Oxford OX2 7LG, United Kingdom (Tel.: +44 1865 513902; Fax: +44 1865 516918).
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absorbable synthetic versus Catgut Suture material for perineal repair
Cochrane Database of Systematic Reviews, 1999Co-Authors: Christine Kettle, Richard JohansonAbstract:BACKGROUND:Approximately 70% of women will experience some degree of perineal trauma following vaginal delivery and will require stitches. This may result in perineal pain and superficial dyspareunia. OBJECTIVES:The objective of this review was to assess the effects of absorbable synthetic Suture material as compared with Catgut on the amount of short and long term pain experienced by mothers following perineal repair. SEARCH STRATEGY:We searched the Cochrane Pregnancy and Childbirth Group trials register. SELECTION CRITERIA:Randomised trials comparing absorbable synthetic (polyglycolic acid and polyglactin) with plain or chromic Catgut Suture for perineal repair in mothers after vaginal delivery. DATA COLLECTION AND ANALYSIS:Trial quality was assessed independently by two reviewers. Data were extracted by one reviewer and checked by the second reviewer. MAIN RESULTS:Eight trials were included. Compared with Catgut, the polyglycolic acid and polyglactin groups were associated with less pain in first three days (odds ratio 0.62, 95% confidence interval 0.54 to 0.71). There was also less need for analgesia (odds ratio 0.63, 95% confidence interval 0.52 to 0.77) and less Suture dehiscence (odds ratio 0.45, 95% confidence interval 0.29 to 0.70). There was no significant difference in long term pain (odds ratio 0.81, 95% confidence interval 0.61 to 1.08). Removal of Suture material was significantly more common in the polyglycolic acid and polyglactin groups (odds ratio 2.01, 95% confidence interval 1.56 to 2.58). There was no difference in the amount of dyspareunia experienced by women. REVIEWER'S CONCLUSIONS:Absorbable synthetic Suture material (in the form of polyglycolic acid and polyglactin Sutures) for perineal repair following childbirth appears to decrease women's experience of short-term pain. The length of time taken for the synthetic material to be absorbed is of concern. A trial addressing the use of polyglactin has recently been completed and this has been included in this updated review.
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The Cochrane Library - Absorbable synthetic versus Catgut Suture material for perineal repair
The Cochrane database of systematic reviews, 1999Co-Authors: Christine Kettle, Richard JohansonAbstract:BACKGROUND Approximately 70% of women will experience some degree of perineal trauma following vaginal delivery and will require stitches. This may result in perineal pain and superficial dyspareunia. OBJECTIVES The objective of this review was to assess the effects of absorbable synthetic Suture material as compared with Catgut on the amount of short and long term pain experienced by mothers following perineal repair. SEARCH STRATEGY We searched the Cochrane Pregnancy and Childbirth Group trials register. SELECTION CRITERIA Randomised trials comparing absorbable synthetic (polyglycolic acid and polyglactin) with plain or chromic Catgut Suture for perineal repair in mothers after vaginal delivery. DATA COLLECTION AND ANALYSIS Trial quality was assessed independently by two reviewers. Data were extracted by one reviewer and checked by the second reviewer. MAIN RESULTS Eight trials were included. Compared with Catgut, the polyglycolic acid and polyglactin groups were associated with less pain in first three days (odds ratio 0.62, 95% confidence interval 0.54 to 0.71). There was also less need for analgesia (odds ratio 0.63, 95% confidence interval 0.52 to 0.77) and less Suture dehiscence (odds ratio 0.45, 95% confidence interval 0.29 to 0.70). There was no significant difference in long term pain (odds ratio 0.81, 95% confidence interval 0.61 to 1.08). Removal of Suture material was significantly more common in the polyglycolic acid and polyglactin groups (odds ratio 2.01, 95% confidence interval 1.56 to 2.58). There was no difference in the amount of dyspareunia experienced by women. REVIEWER'S CONCLUSIONS Absorbable synthetic Suture material (in the form of polyglycolic acid and polyglactin Sutures) for perineal repair following childbirth appears to decrease women's experience of short-term pain. The length of time taken for the synthetic material to be absorbed is of concern. A trial addressing the use of polyglactin has recently been completed and this has been included in this updated review.
Christine Kettle - One of the best experts on this subject based on the ideXlab platform.
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selected cochrane systematic reviews absorbable synthetic versus Catgut Suture material for perineal repair
Birth-issues in Perinatal Care, 2000Co-Authors: Christine Kettle, Richard JohansonAbstract:A substantive amendment to this systematic review was last made on 19 May 1999. Cochrane reviews are regularly checked and updated if necessary. ABSTRACT Background and objectives: Approximately 70% of women will experience some degree of perineal trauma following vaginal delivery and will require stitches. This may result in perineal pain and superficial dyspareunia. The objective of this review was to assess the effects of absorbable synthetic Suture material as compared with Catgut on the amount of short- and long-term pain experienced by mothers following perineal repair. Search strategy: We searched the Cochrane Pregnancy and Childbirth Group trials register. Selection criteria: Randomised trials comparing absorbable synthetic (polyglycolic acid and polyglactin) with plain or chromic Catgut Suture for perineal repair in mothers after vaginal delivery. Data collection and analysis: Trial quality was assessed independently by two reviewers. Data were extracted by one reviewer and checked by the second reviewer. Main results: Eight trials were included. Compared with Catgut, the polyglycolic acid and polyglactin groups were associated with less pain in first three days (odds ratio 0.62, 95% confidence interval 0.54–0.71). There was also less need for analgesia (odds ratio 0,63, 95% confidence interval 0.52–0.77) and less Suture dehiscence (odds ratio 0.45, 95% confidence interval 0.29–0.70). There was no significant difference in long-term pain (odds ratio 0.81, 95% confidence interval 0.61–1.08). Removal of Suture material was significantly more common in the polyglycolic acid and polyglactin groups (odds ratio 2.01, 95% confidence interval 1.56–2.58). There was no difference in the amount of dyspareunia experienced by women. Reviewers' conclusions: Absorbable synthetic Suture material (in the form of polyglycolic acid and polyglactin Sutures) for perineal repair following childbirth appears to decrease women's experience of short-term pain. The length of time taken for the synthetic material to be absorbed is of concern. A trial addressing the use of polyglactin has recently been completed and this has been included in this updated review. Citation: Kettle C, Johanson RB. Absorbable synthetic versus Catgut Suture material for perineal repair (Cochrane Review). In: The Cochrane Library, Issue 4, 1999, Oxford: Update Software. ••• The preceding report is an abstract of regularly updated, systematic reviews prepared and maintained by the Cochrane Collaboration. The full texts of the reviews are available in The Cochrane Library (ISSN 1464-780X). Seehttp://www.update-software.com/cochrane.htmor contact Update Software,info@update.co.uk, for information on subscribing to The Cochrane Library in your area. Update Software Ltd, Summertown Pavilion, Middle Way, Oxford OX2 7LG, United Kingdom (Tel.: +44 1865 513902; Fax: +44 1865 516918).
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absorbable synthetic versus Catgut Suture material for perineal repair
Cochrane Database of Systematic Reviews, 1999Co-Authors: Christine Kettle, Richard JohansonAbstract:BACKGROUND:Approximately 70% of women will experience some degree of perineal trauma following vaginal delivery and will require stitches. This may result in perineal pain and superficial dyspareunia. OBJECTIVES:The objective of this review was to assess the effects of absorbable synthetic Suture material as compared with Catgut on the amount of short and long term pain experienced by mothers following perineal repair. SEARCH STRATEGY:We searched the Cochrane Pregnancy and Childbirth Group trials register. SELECTION CRITERIA:Randomised trials comparing absorbable synthetic (polyglycolic acid and polyglactin) with plain or chromic Catgut Suture for perineal repair in mothers after vaginal delivery. DATA COLLECTION AND ANALYSIS:Trial quality was assessed independently by two reviewers. Data were extracted by one reviewer and checked by the second reviewer. MAIN RESULTS:Eight trials were included. Compared with Catgut, the polyglycolic acid and polyglactin groups were associated with less pain in first three days (odds ratio 0.62, 95% confidence interval 0.54 to 0.71). There was also less need for analgesia (odds ratio 0.63, 95% confidence interval 0.52 to 0.77) and less Suture dehiscence (odds ratio 0.45, 95% confidence interval 0.29 to 0.70). There was no significant difference in long term pain (odds ratio 0.81, 95% confidence interval 0.61 to 1.08). Removal of Suture material was significantly more common in the polyglycolic acid and polyglactin groups (odds ratio 2.01, 95% confidence interval 1.56 to 2.58). There was no difference in the amount of dyspareunia experienced by women. REVIEWER'S CONCLUSIONS:Absorbable synthetic Suture material (in the form of polyglycolic acid and polyglactin Sutures) for perineal repair following childbirth appears to decrease women's experience of short-term pain. The length of time taken for the synthetic material to be absorbed is of concern. A trial addressing the use of polyglactin has recently been completed and this has been included in this updated review.
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The Cochrane Library - Absorbable synthetic versus Catgut Suture material for perineal repair
The Cochrane database of systematic reviews, 1999Co-Authors: Christine Kettle, Richard JohansonAbstract:BACKGROUND Approximately 70% of women will experience some degree of perineal trauma following vaginal delivery and will require stitches. This may result in perineal pain and superficial dyspareunia. OBJECTIVES The objective of this review was to assess the effects of absorbable synthetic Suture material as compared with Catgut on the amount of short and long term pain experienced by mothers following perineal repair. SEARCH STRATEGY We searched the Cochrane Pregnancy and Childbirth Group trials register. SELECTION CRITERIA Randomised trials comparing absorbable synthetic (polyglycolic acid and polyglactin) with plain or chromic Catgut Suture for perineal repair in mothers after vaginal delivery. DATA COLLECTION AND ANALYSIS Trial quality was assessed independently by two reviewers. Data were extracted by one reviewer and checked by the second reviewer. MAIN RESULTS Eight trials were included. Compared with Catgut, the polyglycolic acid and polyglactin groups were associated with less pain in first three days (odds ratio 0.62, 95% confidence interval 0.54 to 0.71). There was also less need for analgesia (odds ratio 0.63, 95% confidence interval 0.52 to 0.77) and less Suture dehiscence (odds ratio 0.45, 95% confidence interval 0.29 to 0.70). There was no significant difference in long term pain (odds ratio 0.81, 95% confidence interval 0.61 to 1.08). Removal of Suture material was significantly more common in the polyglycolic acid and polyglactin groups (odds ratio 2.01, 95% confidence interval 1.56 to 2.58). There was no difference in the amount of dyspareunia experienced by women. REVIEWER'S CONCLUSIONS Absorbable synthetic Suture material (in the form of polyglycolic acid and polyglactin Sutures) for perineal repair following childbirth appears to decrease women's experience of short-term pain. The length of time taken for the synthetic material to be absorbed is of concern. A trial addressing the use of polyglactin has recently been completed and this has been included in this updated review.
Shivaram Prakash - One of the best experts on this subject based on the ideXlab platform.
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comparative study of episiotomy repair absorbable synthetic versus chromic Catgut Suture material
2008Co-Authors: Kurian Joseph, Bhaskaran Shantha, Shivaram PrakashAbstract:Objectives : To compare absorbable synthetic Sutures with chromic Catgut Sutures for episiotomy repair with respect to pain analgesic requirement, nature of wound healing, and removal of residual Suture material. Methods : The study was conducted in a tertiary care hospital for Southern Railway patients. It is a prospective, comparative study between polyglactin 910 rapide 2-0 versus polyglactin 910 1-0 versus chromic Catgut 1-0. For the present study, a total of 150 patients were selected. The patients were divided into 3 groups according to their turn. Outcome studies were pain assessment by visual analogue scale (VAS) in lying, walking and sitting postures, analgesic requirement, nature of wound healing, and removal of residual Suture material. Results: Compared with chromic Catgut, and polyglactin 910, polyglactin 910 rapide group is associated with less pain in walking and sitting postures, and there was less need for analgesics (P<0.05). Removal of residual Suture material was more common in polyglactin 910 (28%). Conclusions: Polyglactin 910 rapide is the better Suture material than polyglactin 910 and chromic Catgut for episiotomy repair in pain perception resulting in less analgesic requirement in postpartum period.
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Comparative study of episiotomy repair: Absorbable synthetic versus chromic Catgut Suture material
2008Co-Authors: Kurian Joseph, Bhaskaran Shantha, Shivaram PrakashAbstract:Objectives : To compare absorbable synthetic Sutures with chromic Catgut Sutures for episiotomy repair with respect to pain analgesic requirement, nature of wound healing, and removal of residual Suture material. Methods : The study was conducted in a tertiary care hospital for Southern Railway patients. It is a prospective, comparative study between polyglactin 910 rapide 2-0 versus polyglactin 910 1-0 versus chromic Catgut 1-0. For the present study, a total of 150 patients were selected. The patients were divided into 3 groups according to their turn. Outcome studies were pain assessment by visual analogue scale (VAS) in lying, walking and sitting postures, analgesic requirement, nature of wound healing, and removal of residual Suture material. Results: Compared with chromic Catgut, and polyglactin 910, polyglactin 910 rapide group is associated with less pain in walking and sitting postures, and there was less need for analgesics (P
Divya Selvaraju - One of the best experts on this subject based on the ideXlab platform.
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comparative study of episiotomy repair absorbable synthetic versus chromic Catgut Suture material
International journal of reproduction contraception obstetrics and gynecology, 2017Co-Authors: Devika Perumal, Divya SelvarajuAbstract:Background: The choice of Suture material for repair of episiotomy or perineal laceration is largely of one’s personal preference. Chromic Catgut was widely used in most institutions. It now appears that chromic Catgut is associated with more postpartum discomfort and hence chromic Catgut has been largely replaced by synthetic absorbable materials like polyglactin and polyglycolic acid. Methods: The study was conducted in Institute of Social Obstetrics and Government Kasturba Gandhi Hospital, Chennai. This is a prospective, comparative study involving two groups. The use of a rapidly absorbing form of synthetic absorbable Suture material, in the repair of episiotomy or perineal laceration in 100 patients during the study period February 2012 to July 2012, were simultaneously compared with the traditional natural absorbable Suture material. Results: With the use of rapidly absorbing polyglactin 910, there was a significant reduction (p=0.000) in the short-term pain, 19 compared to 80 in the control group. With regard to wound dehiscence and the need for resuturing, there was statistically significant difference in the control group (15%) compared to the study group (0%). There was no statistical significance between the two groups in terms of dyspareunia (12.4% vs 10.7%). Conclusions: Fast-absorbing form of Polyglactin seems to be effective in reducing some of the morbidity associated with perineal repair following childbirth. There was significant reduction in the short-term pain and the need for analgesia. The incidence of wound dehiscence was markedly reduced.
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Comparative study of Episiotomy Repair: Absorbable Synthetic Versus Chromic Catgut Suture material
2013Co-Authors: Divya SelvarajuAbstract:INTRODUCTION : Perineal trauma is the most commonly encountered surgery in the day-today practice of an obstetrician. It can be either a spontaneous tear or a surgical (episiotomy) enlargement of the pelvic soft tissue outlet during the last phase of second stage of labor or delivery. The first surgical opening of the perineum in order to prevent severe perineal tear was suggested by Ould, in 1741. However, the first publication in a medical journal about episiotomy was only in 1810. Prevalence of the episiotomy varies around the world depending on whether it is used as a routine or a restricted procedure. Rates vary from 8% in the Netherlands, 13% in England to 25% in USA. The rates are still higher in developing countries, like ours, since the use of restricted episiotomy is not being practiced widely in primigravidas. Although the Cochrane Database Review has now recommended the practice of restrictive episiotomy, routine use of it still continues in most of our maternity units. Prevalence rate of 54.9% and 99% have been reported in West African countries and East European countries respectively. Perineal trauma affects the physical, mental and social well-being of the mother in her peurperium. A large proportion of women suffer short term perineal pain and up to 20% have long term problems like dyspareunia. Other complications involve removal of retained Suture material, wound dehiscence and re-suturing. AIM OF THIS STUDY: To compare absorbable synthetic Sutures with chromic Catgut Sutures for episiotomy repair with respect to pain, analgesic requirement, wound dehiscense, removal of residual Suture material, long term pain & superficial dyspareunia. PRIMARY OBJECTIVE: Whether the synthetic absorbable Suture material is better than the natural absorbable Suture material in relieving the postpartum morbidity associated with episiotomy or perineal laceration repair. PRIMARY OUTCOME : Early short term pain ( up to 48 hrs) • Late short term pain ( up to 7 days) • Use of Analgesia. SECONDARY OUTCOME: • Long term pain • Nature of wound healing • Need for re-suturing • Removal of unabsorbed Suture material INCLUSION CRITERIA: • All patients with an elective episiotomy • Second degree perineal laceration EXCLUSION CRITERIA : Episiotomy incisions extended by instrumental deliveries • Severe anemia • Diabetes mellitus • On drugs like steroids & immunosuppressant • Epidural labor analgesia • Women whose membranes had ruptured for >24hrs • Patients with foul smelling vaginal discharge. MATERIALS AND METHODS: The study was conducted in Institute of Social Obstetrics and Govt. Kasturba Gandhi Hospital, Triplicane, Chennai-5. This is a prospective, comparative study involving two groups of patients selected randomly as per the inclusion criteria. Each group will have 100 women. A) Polyglactin 910 (Fast-absorbing) – group I, B) Chromic Catgut – group II. All women in the reproductive age group, attending the Government Kasturba Gandhi Hospital, who had a normal vaginal delivery, requiring an episiotomy or had a second degree perineal tear, were eligible to enter the trail. Enrolment took place immediately after delivery, after taking their consent. All episiotomies were repaired using the same technique: single continuous sub-cuticular perineal Sutures, by the post-graduates. Mothers were interviewed at 48hrs, 7days, 15days, 6 and 12 wks regarding perineal pain perception, analgesic requirement and dysparuenia. Local examination was done for nature of healing. RESULTS AND ANALYSIS: This study commenced with 100 women in each group who underwent episiotomy or perineal laceration repair. None of the patients in our study had epidural analgesia for pain relief in labor. In our study, all the perineal repairs were performed under local anesthesia by the post graduates in the labor ward. Descriptive statistics were utilized and all results are presented in terms of percentages. Categorical data were compared using Chi Square Test or Fischer’s Exact Test if appropriate. Statistical significance was p
Theo Meert - One of the best experts on this subject based on the ideXlab platform.
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Stability of neuropathic pain symptoms in partial sciatic nerve ligation in rats is affected by Suture material.
Neuroscience Letters, 2005Co-Authors: Ian Robinson, Theo MeertAbstract:Many factors affect the development of neuropathic pain behavior in animal models. In this letter, we describe the differences in the development of neuropathic pain behavior observed when the partial sciatic nerve ligation (PNL) is performed with either a synthetic silk or chromic Catgut ligation. To characterize nociceptive changes over time after surgery, neutral plate, hot plate, Von Frey, pinprick, acetone spray and cold plate testing was performed. The results indicated that a chromic Catgut ligature caused cold allodynia, chemical hyperreactivity, mechanical hyperalgesia and hypersensitivity that remained present for the entire 56 days post-surgical observation period. With the synthetic silk ligature, comparable functional deficits were present in the initial phase after surgery, but several of these deficits diminished over time 21-28 days post-surgery. In conclusion, performing the PNL using chromic Catgut Suture thread gives rise to more robust sensory deficits than when synthetic silk is used. Therefore, the material that is used for the ligature in the partial sciatic ligation model has an effect on the outcome of the observed sensory abnormalities.