A Cochrane review included 16 studies with a total of 8 184 women. Continuous suture techniques compared with interrupted sutures for perineal closure (all layers or perineal skin only) are associated with less pain for up to 10 days postpartum (RR 0.76, 95% CI 0.66 to 0.88; 9 trials, n=3 619). There was an overall reduction in analgesia use associated with the continuous subcutaneous technique versus interrupted stitches for repair of perineal skin (RR 0.70; 95% CI 0.59 to 0.84; 6 trials, n=2 971). Subgroup analysis showed some evidence of reduction in dyspareunia experienced by participants in the groups that had continuous suturing for all layers (RR 0.83, 95% CI 0.70 to 0.98). There was also a reduction in suture removal in the continuous suturing groups versus interrupted (RR 0.56; 95% CI 0.32 to 0.98; 6 trials, n=3 453), but no significant differences were seen in the need for re-suturing of wounds or long-term pain.