Heart-shaped tension-reducing suturing versus conventional interrupted suturing alleviates perineal pain, accelerates resolution of suture reactions, and improves scar quality in primiparous women undergoing perineal repair

OBJECTIVE: To evaluate the efficacy of the heart-shaped tension-reducing suture (HSTRS) versus interrupted suture (IS) in scar quality and postoperative pain relief in primiparous women. METHODS: In this study, 142 women were allocated to HSTRS (n = 61) or IS (n = 81). Pain score was assessed via NRS at multiple timepoints; suture reactions were graded (0-III), and scar quality was evaluated using VSS, OSAS, and PSAS at 42 days, 90 days, and 180 days. RESULTS: The HSTRS group showed significantly lower pain scores (P < 0.0001), faster resolution of suture reactions, and superior scar outcomes across all scales and timepoints (P < 0.01). CONCLUSIONS: HSTRS significantly improves perineal scar quality, alleviates postoperative perineal pain, and accelerates resolution of suture reactions compared with interrupted suturing, supporting its application for better postpartum perineal recovery.