North American Registry of Midwives (NARM) Practice Exam

What gauge suture is recommended for repairing a clitoral tear?

1. 3-0

2. 4-0

3. 5-0

4. 6-0

The correct answer is: 4-0

The recommendation to use a 4-0 suture for repairing a clitoral tear comes from the need for a balance between strength and the delicacy of the tissue involved. The clitoral area is sensitive and involves relatively thin tissue, thus using a finer suture like 4-0 minimizes trauma while providing adequate tensile strength to support healing. Finer sutures, such as 5-0 and 6-0, might not provide enough strength to support the repair effectively, particularly against the forces of normal activity and healing. Conversely, thicker sutures like 3-0 could potentially cause unnecessary tissue bulkiness and increase the risk of complications, such as infection or scarring, due to the larger material disrupting the delicate tissue. Therefore, using 4-0 suture strikes an appropriate compromise, ensuring sufficient strength while maintaining the integrity and healing of the sensitive area. This aligns with current evidence-based practices in midwifery concerning perineal and clitoral repairs.