Continuous versus interrupted technique for repair of episiotomy


  • sundus yousif kellow M.B.Ch.B. University of sulaimani/ college of medicine/department of obstetrics and gynecology
  • salama kamel M.B.Ch.B. University of sulaimani/ college of medicine/department of obstetrics and gynecology
  • Hanaa Al-ani M.B.Ch.B. University of sulaimani/ college of medicine/department of obstetrics and gynecology
  • Lalye Mohammad Wahab M.B.Ch.B. University of sulaimani/ college of medicine/department of obstetrics and gynecology


episiotomy, suturing, perineal trauma, episiotomy morbidity


Background and Objectives: Some degree of perineal trauma following vaginal delivery is common and this may cause several maternal morbidity. This study is to evaluate the repair techniques of continuous versus interrupted methods for repair of episiotomy regarding consumption of suture material and cost, estimation of the pain at short term (2 and 6 weeks), necessity to take out the stitches, infection, dehiscence and dyspareunia.

Methods: A total of 100 labouring women were divided into two groups; the first group (group A) includes 50 women their episiotomies were repaired with continuous, non locking suturing technique. The other group (group B) includes the other 50 women, their episiotomies were repaired with continuous, locking sutures of the vagina, interrupted sutures of the perineal muscles, and interrupted transcutaneous sutures of the perineal skin. The suture material used was the same in both groups (polyglactin 910). The women were observed for the first 12 hours in the hospital, and seen after two weeks and six weeks.

Results: Significantly fewer women reported pain at two weeks postpartum with the continuous technique (96% mild pain and 4% moderate pain) while with interrupted technique 80% had mild pain, 14% moderate pain and 6% severe pain with a P-value of 0.039. Similar results were observed at 6 weeks postpartum, in favor of continuous technique in which no case was reported to have pain compared with 7 cases (14%) reported pain in interrupted group, with a P-value of 0.006. The rate of stitch removal was significantly lower for continuous group in comparison to interrupted group. Breast feeding also showed significant difference, being earlier in onset with the continuous group. Moreover, when the continuous technique was used for repair of all layers, there was a significant reduction in consumption of suture materials and cost.

Conclusions|: This study have showed that perineal repair using continuous suturing technique is superior to interrupted technique by causing less maternal morbidity , early onset of breast feeding, less cost, also with better cosmetic acceptance.


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Howden NL, Weber AM, Meyn LA. Episiotomy use among residents and faculty compared with private practitioners. Obstet Gynecol 2004; 103:114-8.

Samuelsson E, Ladfors L, Lindblom BG, Hagberg H. A prospective observational study on tears during vaginal delivery: occurrence and risk factors. Acta Obstet Gynecol Scand 2002; 81:44-9.

Signorello LB, Harlow BL, Chekos AK, Repke JT. Postpartum sexual functioning and its relationship to perineal trauma: a retrospective cohort study of primiparous women. Am J Obstet Gynecol 2001; 184:881-8.

Rockner G and Fianu-Jonason A .Changed pattern in the use of episiotomy in Sweden. Br J Obstet Gynecol; 106: 95-101.Carroli G, Belizan J. Episiotomy for vaginal birth. Cochrane Database Syst Rev. 2000;(2):CD000081.

ACOG American College of Obstetricians and Gynaecologist, Practice Bulletin. Episiotomy. Obstetric and Gynaecology.2006; 107-62.

Banta HD, Thacker SB. The risks and benefit of episiotomy. 1982; 9:25-30.

Thacker SB, Banta HD. Benefit and risks of episiotomy: an interpretive review of the English language literature, 1860-1980. Obstetrics and Gynecological Survey 1983; 38: 322-338.

Rosenberg AA, Battaglia FC. The new born infant. Current pediatric diagnosis and treatment. 1993; 11: 9-63.

Royal College of Obstetricians and Gynaecologists. Methods and Materials used in Perineal Repair: Green-top Guideline No. 23. London: RCOG; 2004.

Greenberg, , Greenberg J: Pearls on the best suture for episiotomy. J Fam Pract; 2002, 14(4):1-5.

Sandra Ferreira Silva de Almeida1 Maria Luiza Gonzalez Riesco2 .Randomized controlled clinical trial on two perineal trauma suture techniques in normal delivery. Rev Latino-am Enfermagem 2008 março-abril; 16(2):272-9.

Fleming N. Can the Suturing Method make a Difference in Postpartum, Perineal Pain. J Nurse-Midwifery 1990; 35:19–25.

Barrett G, Pendry E, Peacock J, Victor C, Thakar R, Manyonda I. Women's sexual health after childbirth. BJOG 2000; 107:186–95. doi:10.1111/j.1471-0528.2000.tb11689

Handa VL, Danielsen BH, Gilbert WM. Obstetric anal sphincter lacerations. Obstet Gynecol 2001; 98: 225–30.

Pratt JP, Hodgkinson CP, Kennedy CR. Midline episiotomy. Am. J. Obstet. Gynecol.1942; 43: 292-296.

Barter RH, Parks J, Tyndal C. Median episiotomy. Am. J. Obstet. Gynecol.1960; 82: 654-662.

Fleming AR. Complete perineotomy. Obstet. Gynecol.1960; 16: 172-174.

Graczyk, S (S);Limanoski,M(M); Wyduba,M(M). Suture of the episiotomy wound –comparison of two techniques from clinical and cosmetic aspect.1998-Jan; vol 69(issue 1): pp6-11.

Kettle Christine; Hills Robert K; Jones Peter; Darby Louisa; Gray Richard; Johanson Richard. Continuous versus interrupted perineal repair with standard or rapidly absorbed sutures after spontaneous vaginal birth: a randomised controlled trial. 2002, Lancet 2002; 359 (9325):2217-23.

Almeida SF, Riesco ML. Randomized controlled clinical trial on two perineal trauma suture techniques in normal delivery. Rev Lat Am Enfermagem. 2008 Mar-Apr; 16 (2):272-9.

Morano Sandra; Mistrangelo Emanuela; Pastorino Daniela; Lijoi Davide; CostantiniSergio; RagniNicola. A randomized comparison of suturing techniques for episiotomy and laceration repair after spontaneous vaginal birth. Journal of minimally invasive gynecology 2006; 13(5):457-62.

Isager-Sally I, Legarth J, Jacobsen B, Bostofte E. Episiotomy repair -immediate and long-term sequelae. A prospective randomized study of three different methods of repair. British Journal of Obstetrics and Gynaecology 1986; 93: 420–5.

P Valenzuela, MS Saiz Puente, JL Valero, R Azorín, R Ortega, R Guijarro. Continuous versus interrupted sutures for repair of episiotomy or second-degree perineal tears: a randomised controlled trial. British Journal of Obstetrics and Gynaecology 2009 Jan; 116(3):436-41.

DetlefsenGU,Vinther S, Larsen P, Schroeder E. Intradermal suturing of episiotomy wounds compared with interrupted sutures. Ugeskrift for Laeger 1980; 142:3117–20.




How to Cite

kellow, sundus yousif, kamel, salama, Al-ani, H., & Wahab, L. M. (2018). Continuous versus interrupted technique for repair of episiotomy. Zanco Journal of Medical Sciences (Zanco J Med Sci), 14(3 Special), 40–47. Retrieved from



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