Comparison 1. Synthetic sutures versus catgut.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Short‐term pain: pain at day 3 or less (women experiencing any pain)	10		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
1.1 Standard synthetic	9	4017	Risk Ratio (M‐H, Random, 95% CI)	0.83 [0.76, 0.90]
1.2 Fast absorbing	1	908	Risk Ratio (M‐H, Random, 95% CI)	1.02 [0.98, 1.06]
2 Short‐term pain: pain at day 4 ‐ 10	4		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
2.1 Standard synthetic	3	2044	Risk Ratio (M‐H, Fixed, 95% CI)	0.78 [0.67, 0.90]
2.2 Fast absorbing	1	846	Risk Ratio (M‐H, Fixed, 95% CI)	1.05 [0.94, 1.18]
3 Analgesia use ‐ up to day 10	6		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
3.1 Standard synthetic	5	2820	Risk Ratio (M‐H, Random, 95% CI)	0.71 [0.59, 0.87]
3.2 Fast absorbing	1	908	Risk Ratio (M‐H, Random, 95% CI)	0.96 [0.90, 1.01]
4 Suture dehiscence (wound breakdown)	2		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
4.1 Standard synthetic	1	1771	Risk Ratio (M‐H, Fixed, 95% CI)	0.72 [0.23, 2.25]
4.2 Fast absorbing	1	309	Risk Ratio (M‐H, Fixed, 95% CI)	1.02 [0.23, 4.48]
5 Superficial wound dehiscence, wound gaping up to day 10	4	2219	Risk Ratio (M‐H, Random, 95% CI)	0.58 [0.36, 0.94]
5.1 Standard synthetic	4	2219	Risk Ratio (M‐H, Random, 95% CI)	0.58 [0.36, 0.94]
6 Resuturing of wound ‐ up to 3 months	4	2402	Risk Ratio (M‐H, Fixed, 95% CI)	0.25 [0.08, 0.74]
6.1 Standard synthetic	4	2402	Risk Ratio (M‐H, Fixed, 95% CI)	0.25 [0.08, 0.74]
7 Removal of suture material ‐ up to 3 months	4		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
7.1 Standard synthetic	3	2520	Risk Ratio (M‐H, Fixed, 95% CI)	1.81 [1.46, 2.24]
7.2 Fast absorbing	1	309	Risk Ratio (M‐H, Fixed, 95% CI)	0.77 [0.11, 5.37]
8 Long‐term pain ‐ at 3 months postpartum	5		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
8.1 Standard synthetic	4	2525	Risk Ratio (M‐H, Fixed, 95% CI)	0.86 [0.68, 1.09]
8.2 Fast absorbing	2	370	Risk Ratio (M‐H, Fixed, 95% CI)	0.80 [0.55, 1.17]
9 Dyspareunia ‐ at 3 months postpartum	5		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
9.1 Standard synthetic	5	2506	Risk Ratio (M‐H, Random, 95% CI)	0.93 [0.70, 1.24]
9.2 Fast absorbing	1	61	Risk Ratio (M‐H, Random, 95% CI)	0.57 [0.33, 0.97]