| Title |
Randomized trial comparing episiotomies with Braun-Stadler episiotomy scissors and EPISCISSORS-60®
|
|---|---|
| Published in |
Medical Devices : Evidence and Research, June 2015
|
| DOI | 10.2147/mder.s83360 |
| Pubmed ID | |
| Authors |
Ganpat Sawant, Divya Kumar |
| Abstract |
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(®). 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. Thirty-one nulliparae had episiotomies with EPISCISSORS-60(®), 32 with Braun-Stadler. Mean age (25 versus 24.8 years) was similar. EPISCISSORS-60(®) 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(®) 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(®) episiotomies measured longer (47 mm versus 40 mm, P<0.0001). There were no OASIS cases in the EPISCISSORS-60(®) group versus one in the Braun-Stadler group. The EPISCISSORS-60(®) sutured episiotomies are much further away from the midline in angular and distance measures, hence at lower OASIS risk. |
Mendeley readers
The data shown below were compiled from readership statistics for 24 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 24 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 5 | 21% |
| Student > Bachelor | 5 | 21% |
| Student > Ph. D. Student | 2 | 8% |
| Student > Doctoral Student | 1 | 4% |
| Professor | 1 | 4% |
| Other | 5 | 21% |
| Unknown | 5 | 21% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 7 | 29% |
| Psychology | 5 | 21% |
| Nursing and Health Professions | 3 | 13% |
| Engineering | 2 | 8% |
| Linguistics | 1 | 4% |
| Other | 1 | 4% |
| Unknown | 5 | 21% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 July 2015.
All research outputs
#7,993,771
of 25,457,297 outputs
Outputs from Medical Devices : Evidence and Research
#102
of 314 outputs
Outputs of similar age
#88,489
of 281,589 outputs
Outputs of similar age from Medical Devices : Evidence and Research
#5
of 14 outputs
Altmetric has tracked 25,457,297 research outputs across all sources so far. This one has received more attention than most of these and is in the 67th percentile.
So far Altmetric has tracked 314 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.3. This one has gotten more attention than average, scoring higher than 62% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 281,589 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 67% of its contemporaries.
We're also able to compare this research output to 14 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 57% of its contemporaries.