A primigravida undergoes a forceps delivery for prolonged second stage. The procedure is complicated by a third-degree perineal tear extending through the external anal sphincter. What is the recommended method of sphincter repair according to current evidence?

• A End-to-end anastomosis using interrupted sutures
• B Primary repair using interrupted chromic catgut
• C Overlapping repair using delayed absorbable sutures ✓
• D End-to-end anastomosis with figure-of-eight sutures

Explanation

For third-degree tears involving the external anal sphincter, the overlapping repair technique is preferred over end-to-end anastomosis as it provides better anatomical and functional outcomes. The RCOG and ACOG recommend using delayed absorbable sutures such as polyglycolide or polydioxanone.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.