References
®, fever, pains, vomiting, dyspareunia, SD, dehiscence, pain, infection, headache, hematoma
ADVERSE EVENTS, DYSPAREUNIA, DISEASE, INFLAMMATION, DEHISCENCE, INFECTION, SECONDARY, WOUND DEHISCENCE, HEMATOMA, COMPLICATIONS

No further comments to make. Article is approved.Is the work clearly and accurately presented and does it cite the current literature?YesIf applicable, is the statistical analysis and its interpretation appropriate?YesAre all the source data underlying the results available to ensure full reproducibility?YesIs the study design appropriate and is the work technically sound?YesAre the conclusions drawn adequately supported by the results?YesAre sufficient details of methods and analysis provided to allow replication by others?YesReviewer Expertise:High risk obstetrics and adolescent gynecologyI confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.
The article is scientifically valid in its current form.Is the work clearly and accurately presented and does it cite the current literature?YesIf applicable, is the statistical analysis and its interpretation appropriate?PartlyAre all the source data underlying the results available to ensure full reproducibility?YesIs the study design appropriate and is the work technically sound?YesAre the conclusions drawn adequately supported by the results?YesAre sufficient details of methods and analysis provided to allow replication by others?YesReviewer Expertise:Immunology, Cell and Molecular Biology, Angiogenesis, Pathology, AnatomyI confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

 This article aims at describing the type of suture material that can be used to repair the episiotomy. Benefits and complications of using Trusynth Fast and Vicryl Rapide polygactin 910 fast absorbing sutures. Primary outcome analysed was subjective post episiotomy perineal pain with the type of suture material used. Secondary outcomes analysed were quantity of local anesthesia, number of sutures used, time to repair episiotomy, intraoperative suture handling, analgesics used, early and late wound complications, wound re-suturing, time to complete healing, presence of residual sutures, return to sexual activity and dyspareunia. They concluded that Trusynth Fast® suture is clinically equivalent to Vicryl Rapide® suture and can be used for episiotomy repair with minimal risk of perineal pain and wound complications.


Aims and objectives have been mentioned clearly.Review of literature is appropriate for the study.Materials & Methods have been explained in brief.The study area has been defined clearly.Data collection technique is appropriate for the study.Data analysis technique is described in detail.Results have been described and analysed in detail.The discussion has been described clearly and results have been compared with other studies and analysed.
Introduction to the topic has been mentioned in detail.Conclusions and the summary of the study have been defined which is appropriate.Is the work clearly and accurately presented and does it cite the current literature?YesIf applicable, is the statistical analysis and its interpretation appropriate?YesAre all the source data underlying the results available to ensure full reproducibility?YesIs the study design appropriate and is the work technically sound?YesAre the conclusions drawn adequately supported by the results?YesAre sufficient details of methods and analysis provided to allow replication by others?YesReviewer Expertise:High risk obstetrics and adolescent gynecologyI confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.
The manuscript entitled “Clinical equivalence of Trusynth fast® and Vicryl rapide® polyglactin 910 fast absorbing sutures on maternal morbidity experienced by women following episiotomy repair: a single-blind, randomized study” by Devi
 Additional comments:
In the introduction section, provide characteristic features of Trusynth Fast sutures, if any previous studies have been conducted using it; they need not to be randomised but any general studies, suggesting the qualities of the suture.In the methodology section, provide IEC no. of Government Victoria Hospital-King George hospital also, if any, similar to other institute’s registration number.As mentioned in the result section, 100 females were screened and 4 were excluded. Were 100 consecutive women screened for eligibility? If yes, why were further patients not screened or recruited when four patients met exclusion criteria?The study was conducted at two sites. How many patients were recruited from each site?Figure numbers are not consecutive. Figure 1, 3 and then figure 2. Kindly rectify this.In Figure 3, it would be better to mention SD along with mean values of pain score and mean healing score. It is not required to be mentioned for frequency of subjects.In the post-operative profile of secondary endpoint analysis, the authors have mentioned that “The subjects of Vicryl Rapide® group took comparatively longer time for complete healing after episiotomy repair than Trusynth Fast® group, but the difference was not statistically significant (Table 2).” On applying two tailed t-test, the difference is found to be statistically significant with p value= 0.026. I would like to know which statistical test was applied to compare the mean values?How many in clinic and telephonic follow up visits were conducted on Day 11, as mentioned in methodology? How did you verify the adverse events on telephonic follow-up?In the discussion section, I would suggest to add a few studies from the literature to discuss the findings of this study.Is the work clearly and accurately presented and does it cite the current literature?YesIf applicable, is the statistical analysis and its interpretation appropriate?PartlyAre all the source data underlying the results available to ensure full reproducibility?YesIs the study design appropriate and is the work technically sound?YesAre the conclusions drawn adequately supported by the results?YesAre sufficient details of methods and analysis provided to allow replication by others?YesReviewer Expertise:Immunology, Cell and Molecular Biology, Angiogenesis, Pathology, AnatomyI confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.
The manuscript entitled “Clinical equivalence of Trusynth fast


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 Further, the characteristic features of both Trusynth Fast
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 As mentioned in the sample size calculation, 76 females were to be included to attain significance. Thus, further recruitments were not conducted. 4. 

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 I would like to know which statistical test was applied to compare the mean values? Primarily, KS test was done to check the normality. The data was not found to be normally distributed thus, non-parametric approach, Mann-Whitney U test was used which resulted in p-value of 0.175. The difference was found to be statistically non-significant. 8. 

 During telephonic follow-up, the subjects were asked for the occurrence of any disease, injury, or any other signs for assessment of adverse events. In case of severe problems, the patients were asked for in-clinic visit. However, adverse events such as vaginal discharge, fever, general body pains, vomiting, and headache were reported. 9. 

Improvement in perineal pain and a decrease in a number of analgesics with the use of polyglactin 910 suture has been discussed with respect to previous studies by Ononuju et al., 2020; Gupta et al., 2021; Samant et al., 2013 and Kettle et al., 2007 (Reference 2, 6, 9 and 11).Postpartum complications like infection, wound dehiscence and re-suturing, and requirement for hospital re-admissions have been discussed with respect to studies by Boushra and Rahman, 2013, and Dudley et al., 2017 (Reference 12 and 13). In addition, post-episiotomy inflammation, hematoma, infection and dehiscence, pain, extension of the episiotomy incision, and dyspareunia have been discussed after referencing the study of Gun et al., 2016  (Reference 14).Wound healing after episiotomy repair with Trusynth Fast
