Using adhesive glue to repair first degree perineal tears: a prospective randomized controlled trial

Tomer Feigenberg, Esther Maor-Sagie, Einat Zivi, Mushira Abu-Dia, Assaf Ben-Meir, Hen Y Sela, Yossef Ezra, Tomer Feigenberg, Esther Maor-Sagie, Einat Zivi, Mushira Abu-Dia, Assaf Ben-Meir, Hen Y Sela, Yossef Ezra

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.

Figures

Figure 1
Figure 1
Patient's flow diagram.

References

    1. McCandlish R, Bowler U, van Asten H, et al. A randomised controlled trial of care of the perineum during second stage of normal labour. British Journal of Obstetrics and Gynaecology. 1998;105(12):1262–1272.
    1. Sleep J, Grant A, Garcia J, Elbourne D, Spencer J, Chalmers I. West Berkshire perineal management trial. British Medical Journal. 1984;289(6445):587–590.
    1. Kettle C, Tohill S. Perineal care. Clinical Evidence. 2011;2011, article 1401
    1. Mattamal GJ. US FDA perspective on the regulations of medical-grade polymers: cyanoacrylate polymer medical device tissue adhesives. Expert Review of Medical Devices. 2008;5(1):41–49.
    1. Kutcher MJ, Ludlow JB, Samuelson AD, Campbell T, Pusek SN. Evaluation of a bioadhesive device for the management of aphthous ulcers. Journal of the American Dental Association. 2001;132(3):368–376.
    1. Spauwen PHM, de Laat WAA, Hartman EHM. Octyl-2-cyanoacrylate tissue glue (Dermabond) versus monocryl 6 × 0 sutures in lip closure. Cleft Palate-Craniofacial Journal. 2006;43(5):625–627.
    1. Sniezek PJ, Walling HW, DeBloom JR, III, et al. A randomized controlled trial of high-viscosity 2-octyl cyanoacrylate tissue adhesive versus sutures in repairing facial wounds following Mohs micrographic surgery. Dermatologic Surgery. 2007;33(8):966–971.
    1. Strauss EJ, Weil WM, Jordan C, Paksima N. A prospective, randomized, controlled trial of 2-octylcyanoacrylate versus suture repair for nail bed injuries. Journal of Hand Surgery. 2008;33(2):250–253.
    1. Siddiqui DS, Lacuna EM, Chen H, Chauhan SP. Skin closure of pfannenstiel incision with dermabond, staples, or suture during cesarean delivery: Experience of a single attending. American Journal of Perinatology. 2013;30(3):219–224.
    1. Berger A, Worly B. Clitoral avulsion successfully repaired with 2-Octylcyanoacrylate. Journal of Sexual Medicine. 2013;10(7):1889–1892.
    1. Howard BK, Downey SE. Contact dermatitis from dermabond. Plastic and Reconstructive Surgery. 2010;125(6):252e–253e.
    1. McDonald BS, Buckley DA. Severe dermatitis from Dermabond surgical glue. British Journal of Dermatology. 2014;170(3):739–741.
    1. Adoni A, Anteby E. The use of Histoacryl for episiotomy repair. British Journal of Obstetrics and Gynaecology. 1991;98(5):476–478.
    1. Rogerson L, Mason GC, Roberts AC. Preliminary experience with twenty perineal repairs using Indermil tissue adhesive. European Journal of Obstetrics Gynecology and Reproductive Biology. 2000;88(2):139–142.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel