The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform

Emmanuel Bujold - One of the best experts on this subject based on the ideXlab platform.

  • impact of chromic catgut versus Polyglactin 910 versus fast absorbing Polyglactin 910 sutures for perineal repair a randomized controlled trial
    American Journal of Obstetrics and Gynecology, 2006
    Co-Authors: Nathalie Leroux, Emmanuel Bujold
    Abstract:

    Objective The goal of our study was to compare the impact of 3 suture materials on perineal pain and on resumption of sexual intercourse. Study design This randomized, controlled trial compared 3 types of suture materials (chromic catgut, Polyglactin 910, fast-absorbing Polyglactin 910) for second-degree perineal laceration or uncomplicated episiotomy. Patients were enrolled in early labor and assigned randomly to 1 of the 3 suture materials. Pain was evaluated at 48 hours, 6 weeks, and 3 months. The study subjects were questioned about residual perineal pain, resumption of sexual activity, and pain-free sexual intercourse. Logistic regression analyses were undertaken. Results Of the 192 patients who were assigned randomly to groups, 66 patients had their perineal laceration repaired with chromic catgut; 60 patients had repair with Polyglactin 910, and 66 patients had repair with fast-absorbing Polyglactin 910. At 48 hours, there was no significant difference according to the pain measurement scores, but the median consumption of analgesics was significantly lower with fast-absorbing Polyglactin 910 than with standard Polyglactin 910. There was no difference in the resumption of sexual intercourse at 6 weeks after the delivery between chromic catgut (42%) compared with standard Polyglactin 910 group (56%; P = .23). However, it was more frequent for women in the fast-absorbing Polyglactin 910 group (66%; P = .02). After adjustment for confounding variables, perineal repair with fast-absorbing Polyglactin 910 was associated with a higher rate of sexual intercourse (odds ratio, 2.55; 95% CI, 1.07-6.10) and a higher rate of pain-free sexual intercourse (odds ratio, 2.51; 95% CI, 1.03-6.10) at 6 weeks after delivery. Conclusion Fast-absorbing Polyglactin 910 for perineal repair is associated with earlier resumption of sexual intercourse when compared with chromic catgut.

Richard Johanson - One of the best experts on this subject based on the ideXlab platform.

  • selected cochrane systematic reviews absorbable synthetic versus catgut suture material for perineal repair
    Birth-issues in Perinatal Care, 2000
    Co-Authors: Christine Kettle, Richard Johanson
    Abstract:

    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).

  • absorbable synthetic versus catgut suture material for perineal repair
    Cochrane Database of Systematic Reviews, 1999
    Co-Authors: Christine Kettle, Richard Johanson
    Abstract:

    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.

Jeffrey L Ecke - One of the best experts on this subject based on the ideXlab platform.

  • randomized comparison of chromic versus fast absorbing Polyglactin 910 for postpartum perineal repair
    Obstetrics & Gynecology, 2004
    Co-Authors: James A Greenberg, Ellice Lieberma, Amy Cohe, Jeffrey L Ecke
    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

Christine Kettle - One of the best experts on this subject based on the ideXlab platform.

  • selected cochrane systematic reviews absorbable synthetic versus catgut suture material for perineal repair
    Birth-issues in Perinatal Care, 2000
    Co-Authors: Christine Kettle, Richard Johanson
    Abstract:

    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).

  • absorbable synthetic versus catgut suture material for perineal repair
    Cochrane Database of Systematic Reviews, 1999
    Co-Authors: Christine Kettle, Richard Johanson
    Abstract:

    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.

Jeffrey Wacksman - One of the best experts on this subject based on the ideXlab platform.

  • suture material in bladder surgery a comparison of polydioxanone Polyglactin and chromic catgut
    The Journal of Urology, 1990
    Co-Authors: David W. Stewart, Philip J Buffington, Jeffrey Wacksman
    Abstract:

    Abstract A comparison of polydioxanone, Polyglactin, and chromic catgut suture was performed in 120 rat bladders studying propensity for infection, degree of inflammation, calculogenic potential, changes in urine pH, and suture absorption. None of the sutures predisposed to infection and there was wide variability but no correlation in urine pH. Although initially the polydioxanone incited a greater inflammatory response, by six months all three sutures were similar. The absorption of polydioxanone was slower than chromic catgut suture, but similar to the absorption of Polyglactin. There was no significant difference in calculogenic potential between the suture materials tested over a six-month period. Based on this study in rats, polydioxanone suture would appear to be equal to catgut and Polyglactin suture in bladder surgery. (J. Urol, 143: 1261–1263, 1990)