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dc.contributor.authorElharmeel, Suzanen_US
dc.contributor.authorChaudhary, Yasminen_US
dc.contributor.authorTan, Stephanieen_US
dc.contributor.authorScheermeyer, Ellyen_US
dc.contributor.authorHanafy, Ashrafen_US
dc.contributor.authorvan Driel, Miekeen_US
dc.date.accessioned2017-04-24T11:36:06Z
dc.date.available2017-04-24T11:36:06Z
dc.date.issued2011en_US
dc.date.modified2012-05-22T22:23:40Z
dc.identifier.issn1469-493Xen_US
dc.identifier.doi10.1002/14651858.CD008534.pub2en_US
dc.identifier.urihttp://hdl.handle.net/10072/42893
dc.description.abstractBackground Perineal tears commonly occur during childbirth. They are sutured most of the time. Surgical repair can be associated with adverse outcomes, such as pain, discomfort and interference with normal activities during puerperium and possibly breastfeeding. Surgical repair also has an impact on clinical workload and human and financial resources. Objectives To assess the evidence for surgical versus non-surgical management of first- and second-degree perineal tears sustained during childbirth. Search strategy We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (1 May 2011), CENTRAL (The Cochrane Library 2011, Issue 2 of 4) and MEDLINE (Jan 1966 to 2 May 2011). We also searched the reference lists of reviews, guidelines and other publications and contacted authors of identified eligible trials. Selection criteria Randomised controlled trials (RCTs) investigating the effect on clinical outcomes of suturing versus non-suturing techniques to repair first- and second-degree perineal tears sustained during childbirth. Data collection and analysis Two review authors independently assessed trials for inclusion and assessed trial quality. Three review authors independently extracted data. Main results We included two RCTs (involving 154 women) with a low risk of bias. It was not possible to pool the available studies. The two studies do not consistently report outcomes defined in the review. However, no significant differences were observed between the two groups (surgical versus non-surgical repair) in incidence of pain and wound complications, self-evaluated measures of pain at hospital discharge and postpartum and re-initiation of sexual activity. Differences in the use of analgesia varied between the studies, being high in the sutured group in one study. The other trial showed differences in wound closure and poor wound approximation in the non-suturing group, but noted incidentally also that more women were breastfeeding in this group. Authors' conclusions There is limited evidence available from RCTs to guide the choice between surgical or non-surgical repair of first- or second-degree perineal tears sustained during childbirth. Two studies find no difference between the two types of management with regard to clinical outcomes up to eight weeks postpartum. Therefore, at present there is insufficient evidence to suggest that one method is superior to the other with regard to healing and recovery in the early or late postnatal periods. Until further evidence becomes available, clinicians' decisions whether to suture or not can be based on their clinical judgement and the women's preference after informing them about the lack of long-term outcomes and the possible chance of a slower wound healing process, but possible better overall feeling of well being if left un-sutured.en_US
dc.description.peerreviewedYesen_US
dc.description.publicationstatusYesen_US
dc.format.extent271373 bytes
dc.format.mimetypeapplication/pdf
dc.languageEnglishen_US
dc.language.isoen_US
dc.publisherJohn Wiley & Sonsen_US
dc.publisher.placeUnited Kingdomen_US
dc.relation.ispartofstudentpublicationNen_US
dc.relation.ispartofpagefrom1en_US
dc.relation.ispartofpageto21en_US
dc.relation.ispartofissue8en_US
dc.relation.ispartofjournalCochrane Database of Systematic Reviewsen_US
dc.relation.ispartofvolume2011en_US
dc.rights.retentionYen_US
dc.subject.fieldofresearchMedical and Health Sciences not elsewhere classifieden_US
dc.subject.fieldofresearchcode119999en_US
dc.titleSurgical repair of spontaneous perineal tears that occur during childbirth versus no interventionen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Peer Reviewed (HERDC)en_US
dc.type.codeC - Journal Articlesen_US
gro.rights.copyrightCopyright 2011 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd. This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2011, Issue. 8. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.en_US
gro.date.issued2011
gro.hasfulltextFull Text


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