{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T11:33:36Z","timestamp":1767008016259,"version":"3.40.5"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T00:00:00Z","timestamp":1566345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["K12 HD065257"],"award-info":[{"award-number":["K12 HD065257"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Perineal lacerations during childbirth are common, and suturing the perineal skin during repair has been associated with increased postpartum pain. This study sought to test the hypothesis that no difference in postpartum perineal pain exists between 3 methods of skin closure for second\u2010degree repair: suture, no suture, and surgical glue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A single\u2010blind randomized controlled trial of women after vaginal birth who had a second\u2010degree perineal laceration was conducted at a tertiary care teaching hospital from August 2014 to April 2017. Women were randomized to perineal skin closure with suture, no suture, or surgical glue using a 1:1:1 allocation. Pain was assessed using the short\u2010form McGill Pain Questionnaire, a 100\u2010mm visual analog scale (VAS), and Present Pain Index (PPI) at one day, 2 weeks, 6 weeks, and 3 months postpartum. Wound healing was assessed at 6 weeks using the Redness, Edema, Ecchymosis, Drainage, Approximation (REEDA) scale. Pain scores were compared across groups using a chi\u2010square test, Mann\u2010Whitney <jats:italic>U<\/jats:italic> test, or analysis of variance where appropriate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 35 women were randomized: 14 received suture, 11 had no suture, and 10 received surgical glue for perineal skin repair. Demographic characteristics were similar between groups. At 2 weeks postpartum, women with suture had higher median pain scores on the short\u2010form McGill Pain Questionnaire (15.0 suture vs 2.0 glue vs 2.0 no suture, <jats:italic>P<\/jats:italic> = .03) and VAS (50.0 suture vs 3.0 glue vs 7.0 no suture, <jats:italic>P<\/jats:italic> = .02). Significant differences in pain were not seen on the PPI. At 3 months, women in the suture group had higher median pain scores on the short\u2010form McGill Pain Questionnaire compared with surgical glue (1.0 vs 0, <jats:italic>P<\/jats:italic> = .04). Wound healing was similar across groups (REEDA score: 0 suture vs 1.0 no suture, vs 0 surgical glue, <jats:italic>P<\/jats:italic> = .24).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Compared with no suture and surgical glue, suturing the perineal skin was associated with the highest postpartum pain scores.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jmwh.13020","type":"journal-article","created":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T10:39:39Z","timestamp":1566383979000},"page":"567-577","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Randomized Trial of 3 Techniques of Perineal Skin Closure During Second\u2010Degree Perineal Laceration Repair"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3220-9445","authenticated-orcid":false,"given":"Carolyn W.","family":"Swenson","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan  Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa Kane","family":"Low","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan  Ann Arbor Michigan"},{"name":"School of Nursing University of Michigan  Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine M.","family":"Kowalk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan  Ann Arbor Michigan"},{"name":"Department of Physician Assistant Studies University of Toledo  Toledo Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dee E.","family":"Fenner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan  Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-59"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002841"},{"key":"e_1_2_8_4_1","article-title":"Continuous and interrupted suturing techniques for repair of episiotomy or second\u2010degree tears","volume":"11","author":"Kettle C","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000006.pub2"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.113855"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.11.604"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1998.tb10130.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2007.05.060222"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/526590"},{"issue":"8","key":"e_1_2_8_11_1","article-title":"Surgical repair of spontaneous perineal tears that occur during childbirth versus no intervention","author":"Elharmeel SM","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340902883133"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjom.2002.10.7.10582"},{"key":"e_1_2_8_14_1","unstructured":"Indermil tissue adhesive [package insert]. 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