Do synthetic absorbable sutures cause less uterine tissue reactions than catgut in bovine caesarean sections?

PICO Question In bovines undergoing caesarean section does the use of synthetic absorbable uterine sutures compared with catgut result in less uterine tissue reactions? Clinical bottom line Category of research Treatment. Number and type of study designs reviewed Three studies were critically appraised. Two were non-randomised controlled trials and one was a randomised controlled trial. Strength of evidence Weak. Outcomes reported One study found no difference in the incidence of uterine adhesions between plain catgut and polyglactin 910. Two other studies, which were both conducted on the same group of animals using chromic catgut and polyglycolic acid (PGA), demonstrated a lower incidence and severity of uterine adhesions, as well as reduced histopathological indicators of uterine tissue damage, with polyglycolic acid sutures compared to chromic catgut. Conclusion There is limited evidence concerning the difference in uterine tissue reactions caused when using catgut or a synthetic uterine suture material in bovine caesarean surgeries. The lack of comparability between the relevant studies in terms of population characteristics and type of suture material used (chromic and plain catgut) does not allow a clear conclusion to be made. In addition, uterine adhesion formation is likely to be multifactorial and there is no overall clear indication that the use of synthetic absorbable suture materials is superior in terms of reduced uterine tissue reactions. There are several other papers of interest which may provide further evidence, but these are not available in English and are therefore outside the scope of this Knowledge Summary.