Synthetic line of junction material...

Synthetic line of junction materials have several advantages in perineal repair, including les inflammatory rejoinder reduced discomfort, and lack of in all senses to animal-derived products. Conversely, their longer degradation periods could lead to defered discomfort from foreign material that could also provide a nidus for infection. modern synthetic materials claim to be absorbed rapidly and thus to minimize these disadvantages. Greenberg and colleagues compared the performance of a fast-absorbing polyglactin with that of a chromic catgut line of junction in a randomized trial.

They studied mothers admitted to a teaching hospital for trial of labor. Women who complianceed to participate in the subject of attention were assigned randomly before labor to chromic catgut or fast-absorbing synthetic line of junction If perineal sutures were required, the patient was treated using the assigned line of junction (unless the attending physician believed an alternative line of junction was indicated). Data were aggregateed on the details of the deliveries, and the participating mothers were interviewed 24 to 48 hours after delivery about pain and other symptoms. Mothers were interviewed again 10 to 14 days and six to eight weeks after delivery.

The 459 mothers who received fast-absorbing polyglactin were similar in all important prizes to the 449 mothers treated with chromic catgut. At the initial assessment (after 24 to 48 hours), uterine pain was significantly les habitual in mothers assigned to the synthetic line of junction but no difference was noted between the collections in analgesic use. At 10 to 14 days, the form into groupss did not differ in reported pain. through the six- to eight-week follow-up examination, uterine cramping pain was exceptional overall but significantly less prevalent in mothers assigned to treatment with fast-absorbing polyglactin (1 percent compared with 4 percent) Analgesic use was significantly lower in mothers treated with synthetic line of junction (5 percent compared with 10 percent)

The clusters did not differ in injury break-down or signs of residual line of junction material. None of the physicians who initially preferr the fast-absorbing synthetic line of junction changed his or her precedence at the end of the study; however, united half of the 41 physicians who initially preferr another line of junction switched to polyglactin after the study

The authors infer that fast-absorbing polyglactin provides comparable or improved patient comfort and is rarely associated with late complications in perineal repair.

ANNE D WALLING, MD

Greenberg JA, et al. Randomized comparison of chromic versus fast-absorbing polyglactin 910 for postpartum peri-neal repair. Obstet Gynecol June 2004;103:1308-13

COPYRIGHT 2005 American Academy of Family Physicians

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