干旱区生态环境知识资源中心(Arid): Randomized trial comparing episiotomies with Braun-Stadler episiotomy scissors and EPISCISSORS-60 (R)

Arid

DOI	10.2147/MDER.S83360
	Randomized trial comparing episiotomies with Braun-Stadler episiotomy scissors and EPISCISSORS-60 (R)
	Sawant, Ganpat; Kumar, Divya
通讯作者	Sawant, G
来源期刊	MEDICAL DEVICES-EVIDENCE AND RESEARCH
ISSN	1179-1470
出版年	2015
卷号	8 页码:251-254
英文摘要	Introduction: Episiotomy angle is a crucial factor in causation of obstetric anal sphincter injuries (OASIS), which are the major cause of female bowel incontinence. Sutured episiotomies angled too close to the midline (, 30 degree) or too far away from the midline (> 60 degree) fail to unload the perineum sufficiently and predispose to OASIS. A 25-degree post-delivery episiotomy suture angle has a 10% risk of OASIS while 45-degree episiotomy is associated with 0.5% risk. To account for perineal distension at crowning, a 60-degree episiotomy incision is required to achieve 43-50 degree suture angles. We compared episiotomy suture angles with commonly used Braun-Stadler episiotomy scissors with the new fixed angle EPISCISSORS-60((R)). Methods: Ethical approval was obtained. A prospective cluster randomization design was chosen. Thirty-one patients were required in each group for a 12-degree difference with power at 90% and 5% significance. Sutured episiotomy angles and post-delivery linear distance from caudal end of the sutured episiotomy to the anus were measured with protractors and rulers. Two-tailed t-tests were used to compare the two groups. Results: Thirty-one nulliparae had episiotomies with EPISCISSORS-60((R)), 32 with Braun-Stadler. Mean age (25 versus 24.8 years) was similar. EPISCISSORS-60((R)) episiotomies were angled 12 degrees more laterally away from the anus compared to Braun-Stadler (40.6 degrees, 95% confidence interval [CI] +/- 2, interquartile range [IQR] 35-45 versus 28.3 degrees, 95% CI +/- 2, IQR 25-30, P < 0.0001). The post-delivery linear distance from caudal end of the sutured episiotomy to the anus was 15 mm more with the EPISCISSORS-60((R)) compared to Braun-Stadler (35 mm, 95% CI +/- 2.2, IQR = 30-39 versus 19.5; 95% CI +/- 1.3, IQR = 14.75-22.25 P < 0.0001). EPISCISSORS-60((R)) episiotomies measured longer (47 mm versus 40 mm, P < 0.0001). There were no OASIS cases in the EPISCISSORS-60((R)) group versus one in the Braun-Stadler group. Conclusion: The EPISCISSORS-60((R)) sutured episiotomies are much further away from the midline in angular and distance measures, hence at lower OASIS risk.
英文关键词	episiotomy EPISCISSORS-60((R)) obstetric anal sphincter injuries (OASIS) perineal tears
类型	Article
语种	英语
开放获取类型	DOAJ Gold, Green Published
收录类别	ESCI
WOS记录号	WOS:000213895300028
WOS类目	Engineering, Biomedical
WOS研究方向	Engineering
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/331028
作者单位	[Sawant, Ganpat; Kumar, Divya] Dr DY Patil Med Coll & Hosp, Navi Mumbai, India
推荐引用方式 GB/T 7714	Sawant, Ganpat,Kumar, Divya. Randomized trial comparing episiotomies with Braun-Stadler episiotomy scissors and EPISCISSORS-60 (R)[J],2015,8:251-254.
APA	Sawant, Ganpat,&Kumar, Divya.(2015).Randomized trial comparing episiotomies with Braun-Stadler episiotomy scissors and EPISCISSORS-60 (R).MEDICAL DEVICES-EVIDENCE AND RESEARCH,8,251-254.
MLA	Sawant, Ganpat,et al."Randomized trial comparing episiotomies with Braun-Stadler episiotomy scissors and EPISCISSORS-60 (R)".MEDICAL DEVICES-EVIDENCE AND RESEARCH 8(2015):251-254.