Poitiers University Hospital, Department of Obstetrics and Gynecology, Poitiers, France; Poitiers Midwifery School, University of Poitiers, France.
Poitiers Midwifery School, University of Poitiers, France.
J Gynecol Obstet Hum Reprod. 2020 May;49(5):101634. doi: 10.1016/j.jogoh.2019.101634. Epub 2019 Sep 6.
To investigate the prevalence of perineal suture techniques then to identify the factors influencing suturing technique choices.
Prospective, observational, monocentric study over 20 weeks in a university hospital. A personal questionnaire was completed by medical practitioners performing perineal sutures: years of experience, training attendance, suturing techniques usually used for degrees 1 and 2 tears/episiotomies. For each delivery with perineal tear/episiotomy, the professional answered on the type of suture performed and the reasons for choosing this technique. We distinguished discontinuous sutures (several stitches/continuous locking stitch) from continuous sutures (single thread, single continuous locking stitch). We evaluated the prevalence of the techniques used in our center as well as the factors associated with the choice of technique, then we described the characteristics of the professionals who responded to the survey and their suturing habits.
Among the 401 perineal sutures, 45.4% of them were continuous (n = 182), discontinuous sutures were more performed. Discontinuous sutures were more common in 1st and 2nd degree tears. Residents/obstetricians performed significantly more continuous sutures than midwives. Whatever the type of suture technique used (continuous or discontinuous), professionals sutured in the way they felt most suitable to the degree of tearing/episiotomy. Fifty-one percent of midwives are trained in continuous technique, compared with 81% of residents/obstetricians. Midwives required training in 70% of cases and 64% of residents.
It appears necessary to disseminate continuous suture techniques and to promote their training in order to improve our practices.
调查会阴缝合技术的流行情况，然后确定影响缝合技术选择的因素。
这是一项在大学医院进行的 20 周前瞻性、观察性、单中心研究。进行会阴缝合的医务人员填写个人问卷：工作年限、参加培训情况、1 度和 2 度撕裂/会阴切开术通常使用的缝合技术。对于每一例有会阴撕裂/会阴切开的分娩，专业人员回答所进行的缝合类型以及选择该技术的原因。我们将间断缝合（几针/连续锁边缝合）与连续缝合（单根线、单连续锁边缝合）区分开来。我们评估了我们中心使用的技术的流行程度以及与技术选择相关的因素，然后描述了对调查做出回应的专业人员的特征及其缝合习惯。
在 401 例会阴缝合中，连续缝合占 45.4%（n=182），间断缝合更为常见。1 度和 2 度撕裂中更常见间断缝合。住院医师/妇产科医生比助产士更常进行连续缝合。无论使用哪种缝合技术（连续或间断），专业人员都会根据撕裂/会阴切开的程度选择他们认为最合适的方法进行缝合。51%的助产士接受过连续技术培训，而住院医师/妇产科医生为 81%。助产士在 70%的情况下需要培训，而住院医师为 64%。
似乎有必要传播连续缝合技术，并促进其培训，以改善我们的实践。
