183: Use of adhesive glues for the treatment of first degreee perineal tears: a prospective randomized controlled trial

To compare the use of adhesive glues and surgical suturing for the treatment of first degree perineal tears. As many as 30% of women will suffer from a perineal tear after birth. Most of these are first degree tears, involving the skin of the vulva and vagina, with no involvement of the underlying muscle. Traditionally, most of these tears are sutured. The use of adhesive glues has not been used for perineal tears although was proven to be effective and safe for a variety of other surgical incisions and traumatic wounds. A prospective randomized controlled trial in a tertiary center. Women with first degree perineal tear were assigned immediately after giving birth for adhesive glue or suturing, in a ratio of 2:1. All participants and gynecologists performing the procedure filled a questioner at the end of the procedure in the delivery room. All women were examined before they were discharged from the hospital, to assure that there were no procedure failures. All women were summoned for reevaluation at least six weeks post partum, by a gynecologist who was blinded to the type of procedure. A second questioner regarding the quality of the wound healing was filled by the examining gynecologist. All women have filled a second questioner regarding their satisfaction. The study included 21 women in the suturing arm and 48 in the adhesive glue arm. There was no statistical difference in cosmetic or functional results between the two groups. Women who were treated with adhesive glue, were more satisfied with the treatment, as compare to women who were sutured (p=0.035). There was no difference in the duration of pain postpartum between the two groups. 29 women, who participated in the study, were sutured after prior vaginal birth. 93% of these women prefer the use of adhesive glue to traditional suturing. Our results indicate that the use of adhesive glue is a reasonable alternative for suturing, for woman with first degree perineal tear after birth.