During childbirth, situations often arise when it is necessary to put stitches. Their presence requires increased caution from a young mother and, of course, certain skills in caring for this temporary "risk zone".
If childbirth proceeded through natural birth canal, then the sutures are the result of the restoration of the soft tissues of the cervix, vagina, and perineum. Recall the reasons that could lead to the need for suturing.
Cervical ruptures most often occur in a situation where the cervix has not yet fully opened, and the woman begins to push. The head puts pressure on the cervix, and the latter is torn.
Incision at the crotch may appear for the following reasons:
- quick delivery - in this case, the fetal head experiences significant stress, so doctors make it easier for the baby to pass through the perineum: this is necessary in order to reduce the likelihood of injuries to the baby's head;
- - dissection of the perineum pursues the same goals as in a quick birth;
- baby is born in - the tissues of the perineum are dissected so that there are no obstacles at the birth of the head;
- at anatomical features woman's crotch (tissues are inelastic or there is a scar from previous births), due to which the baby's head cannot be born normally;
- mother-to-be should not push due to severe myopia or for some other reason;
- there are signs of a threatened perineal rupture - in this case, it is better to make an incision, since the edges of the wound made with scissors grow together better than the edges of the wound formed as a result of a rupture.
If the baby was born with operations, then the young mother has postoperative suture on the front abdominal wall.
Various materials are used for suturing the perineum and anterior abdominal wall. The choice of a doctor depends on the indications, the available options, the technique adopted in this medical institution, and other circumstances. Thus, synthetic or natural self-absorbable sutures, non-absorbable sutures or metal staples may be used. The last two types of suture materials are removed on the 4-6th day after childbirth.
Now that we have remembered why seams can appear, let's talk about how to care for them. If there is a seam, the young mother should be fully equipped and know how to behave so that the rehabilitation period goes as smoothly as possible, does not leave any unpleasant consequences.
Healing small wounds and sutures occur within 2 weeks - 1 month after delivery, deeper injuries heal much longer. In the postpartum period, all precautions must be observed so that an infection does not develop at the site of the sutures, which can then enter the birth canal. Proper Care behind the damaged perineum will reduce pain and accelerate wound healing.
For care stitches on the cervix and the walls of the vagina, it is enough only to observe the rules of hygiene, no additional care not required. These sutures are always applied with absorbable material, so they are not removed.
in the maternity hospital seams on the crotch the midwife of the department processes 1-2 times a day. To do this, she uses "brilliant green" or a concentrated solution of "potassium permanganate".
The stitches on the perineum, as a rule, are also applied with absorbable threads. The nodules fall off on the 3rd-4th day - on the last day of stay in the hospital or in the first days at home. If the suture was applied with a non-absorbable material, then the sutures are also removed on the 3-4th day.
In the care of the seams on the perineum, personal hygiene also plays an important role. Every two hours, you need to change the pad or diaper, regardless of its filling. It is necessary to use only loose cotton underwear or special disposable panties. The use of tight underwear is categorically excluded, as it exerts significant pressure on the perineum, which disrupts blood circulation, preventing healing.
It is also necessary to wash yourself every 2 hours (after each visit to the toilet; you need to go to the toilet exactly at such a frequency that the filled bladder did not interfere with uterine contractions). In the morning and evening, when you take a shower, the perineum should be washed with soap, and during the day you can simply wash it with water. It is necessary to wash the seam on the perineum thoroughly enough - you can simply direct a jet of water at it. After washing, you need to dry the perineum and the seam area by blotting the towel from front to back.
If there are stitches on the perineum, a woman is not allowed to sit down for 7-14 days (depending on the degree of damage). At the same time, you can sit on the toilet already on the first day after childbirth. By the way, about the toilet. Many women are afraid of severe pain and try to skip bowel movements, as a result, the load on the muscles of the perineum increases and the pain intensifies. As a rule, in the first day or two after childbirth, there is no stool due to the fact that before childbirth the woman was given a cleansing enema, and during childbirth the woman in labor does not take food. The chair appears on the 2-3rd day. To avoid, do not eat foods that have a fixing effect. If the problem of constipation is not new to you, drink a tablespoon before each meal. vegetable oil. The stool will be soft and will not affect the healing process of the stitches.
In the vast majority of cases, it is recommended to sit down on the 5-7th day after childbirth - on the buttock opposite to the side of the injury. You need to sit on a hard surface. On the 10-14th day, you can sit on both buttocks. The presence of stitches on the perineum must be taken into account when traveling home from the maternity hospital: it will be convenient for a young mother to lie or half-sitting in the back seat of the car. It is good if the baby at the same time comfortably settles in his personal car seat and does not occupy his mother's hands.
It happens that the scars remaining after the healing of the sutures still cause discomfort and pain. They can be treated with heating, but not earlier than two weeks after birth, when it has already decreased. To do this, use "blue", infrared or quartz lamps. The procedure should be carried out for 5-10 minutes from a distance of at least 50 cm, but if a woman has a sensitive White skin, it must be increased to a meter to avoid burns. This procedure can be done independently at home after consulting a doctor or in the physiotherapy room. If a woman feels discomfort at the site of the formed scar, the scar is rough, then the doctor may recommend contractubex ointment to eliminate these phenomena - it should be applied 2 times a day for several weeks. With the help of this ointment, it will be possible to achieve a decrease in the volume of scar tissue formed, to reduce discomfort in the scar area.
After a caesarean section, the sutures are observed especially carefully. Within 5-7 days after the operation (before removing the sutures or staples), the procedural nurse of the postpartum department processes the postoperative suture daily antiseptic solutions(for example, "brilliant green") and changes the bandage. On the 5-7th day, the sutures and the bandage are removed. If the wound was sutured with absorbable suture material (such material is used when applying the so-called cosmetic suture), then the wound is treated in the same mode, but the sutures are not removed (such threads are completely absorbed on the 65-80th day after the operation).
The skin scar is formed approximately on the 7th day after the operation; therefore, already a week after a caesarean section, you can safely take a shower. Just do not rub the seam with a washcloth - this can be done in another week.
Having a caesarean section is pretty serious. surgical intervention, in which the incision passes through all layers of the anterior abdominal wall. Therefore, of course, a young mother is worried about pain in the area surgical intervention. In the first 2-3 days, painkillers, which are administered intramuscularly to a woman, help to cope with painful sensations. But already from the first days to reduce pain Mom is recommended to wear a special postpartum or tie up her stomach with a diaper.
After a caesarean section, young mothers often have a question: will the seam open if you take the baby in your arms? Indeed, after abdominal operations surgeons do not allow their patients to lift more than 2 kg for 2 months. But how to say this to a woman who has to take care of a baby? Therefore, obstetricians do not recommend postpartum women after a cesarean section during the first time (2-3 months) to lift more than 3-4 kg, that is, more than the weight of the child.
If pain, redness occurs in the suture area on the perineum or on the anterior abdominal wall, discharge from the wound appears: bloody, purulent or any other, then this indicates the occurrence of inflammatory complications - suppuration of the sutures or their divergence. In this case, you must consult a doctor.
Depending on the severity of the condition, the doctor will prescribe to the woman local treatment. In the presence of purulent-inflammatory complications, this can be Vishnevsky's ointment or synthomycin emulsion (they are used for several days), then, when the wound is cleared of pus and begins to heal, Levomekol is prescribed, which promotes wound healing.
Once again, I would like to emphasize that the treatment of complications should take place only under the guidance of a doctor. It is possible that a midwife will come to the patient's home to process the stitches, or maybe the young mother herself will have to go to women's consultation where this procedure will be carried out.
Elena Martynova,
Obstetrician-gynecologist
Why do stitches hurt after childbirth?
Because it is a sutured wound that appeared as a result of a rupture or incision of the perineum. After a week, you will be much better, but you will fully recover in about 8 weeks, or even six months ...Let's see what suturing is, how they are applied and how a woman is treated in the future.
Internal - superimposed on ruptures of the cervix and vagina, usually do not hurt and do not require any special care. They are superimposed from absorbable materials, they do not need to be removed, they also do not need to be processed in any way, there is no need to smear or douche, you just need to ensure complete sexual rest for at least 2 months, because here they are in far from ideal conditions.
In order for the wound to heal well, it needs rest and asepsis. Neither one nor the other can be fully provided, the mother will still have to get up to the child, she will have to walk. It is impossible to apply any bandage in this area, and postpartum discharge creates nutrient medium for microbes, which is why it is quite common for the sewn-in places to come apart.
Crotches can be sutured using different methods and materials, but almost always these are removable options (they will need to be eliminated for 5-7 days). Most often, if everything goes well, they are removed even in the hospital, before discharge.
Processing of sewn places in the maternity hospital is carried out by a midwife. This can be done both on the examination chair and right in the ward. Usually treated with brilliant green 2 times a day. In the first two weeks, the pain is very pronounced, it is difficult to walk, and it is forbidden to sit, mothers feed lying down, eat either standing or lying down.
After removing the surgical threads and discharge from the hospital, the woman will not be able to sit normally for almost a month. At first, it will only be possible to sit sideways on hard, and even from the hospital you will have to return reclining in the car in the back seat.
How long do stitches heal after childbirth?
At least 6 weeks you will feel discomfort in the area where the perineum was torn. Yes, and care at first will have to be very thorough.Stitch care after childbirth
- Self-absorbable options in the vagina and in the cervix do not need special care.External threads require careful care. Their imposition is most often done in layers, using removable material.
After applying them, you will have to wash yourself after each visit to the toilet. clean water with the addition of potassium permanganate, and dry the crotch thoroughly with a clean towel.
Pads will need to be changed very often as the wound needs dryness. While you are in the hospital, the midwife will perform the treatment.
Removing the threads is a painless procedure, which largely eliminates discomfort.
In the first days, it will be necessary to delay the first stool as much as possible, especially with ruptures of the 3rd degree, in the future it will be called using candles.
It will be necessary for some time to refrain from cereals and bread, vegetables and other stool-stimulating foods. Usually this does not cause big problems, since a cleansing enema is performed before childbirth, which in itself is able to delay stool.
The divergence of suturing most often occurs in the first days or immediately after their removal, rarely later. The reason may be early sitting down, sudden movements, as well as such a complication as suppuration. This is not a common complication that occurs with serious perineal tears, 2-3 degrees.
If there is inflammation, redness, sharp pains in the perineum, premature removal of the perineal rupture-retaining material before the wound is completely healed is not good, because this forms a rough scar. How to treat the wound, the gynecologist will tell you.
If early period went well, healing is proceeding without complications, after discharge from the hospital, only hygiene measures. Perhaps Bepanten or another softening and healing ointment will be recommended.
When do stitches heal completely after childbirth?
On average, discomfort disappears after 2 weeks, but sex will be unpleasant for at least 2 months after the birth of the child. During healing, a scar is formed, which somewhat narrows the entrance to the vagina, making sex painful.The choice of the most painless pose, which is different for each couple, and the use of ointments against scars, for example, contractubex, will help to cope with this.
Strange sensations in the vaginal area can bother you for quite a long time, up to six months. However, in the future, they completely resolve.
When to suspect that something is going wrong:
- If you have already been discharged home, and the sutured area is bleeding. Sometimes bleeding occurs as a result of wound dehiscence. You will not be able to fully examine yourself on your own, so hurry back to the doctor.If internal stitched wounds hurt. Normally, after suturing vaginal tears, there may be slight pain for 1-2 days, but they quickly pass. A feeling of heaviness, fullness, pain in the perineum may indicate the accumulation of hematoma (blood) in the area of damage. This usually happens in the first three days after childbirth, you will still be in the hospital, report this feeling to your doctor.
Sometimes suturing fester after discharge from the hospital. At the same time, a painful swelling is felt in the wound area, the skin here is hot, a high temperature may rise.
In all these cases, you should not think on your own how to smear the wound, you need to urgently contact a gynecologist.
The happiness that engulfs a woman at the same time cannot be expressed in words, all the pain, all the torment experienced just a few minutes ago is forgotten. But in order to calmly hold the baby in your arms, you will have to work a little and suffer.
The most unpleasant, painful and for a long time ranks first when the cervix opens. But the second - the birth of a baby - is a matter of minutes, which, however, can overshadow or (worse) a rupture of the perineum. Some women resist the incision as best they can: they are indignant and even scream. But you need to understand that this manipulation is sometimes simply necessary.
The birth canal can be narrow for the baby, and if the doctor does not make an incision, then the child will do it himself. Then it will be tear with irregularly shaped torn edges, and it will be quite difficult to sew it up, not to mention the fact that it will be long and painful to heal.
But the incision made with a scalpel is even and neat, will allow just a few stitches to bring the edges together. Such a seam will heal quickly and will not deliver special trouble if properly cared for and handled.
External (external) and internal seams after childbirth
Internal seams superimposed with rupture of the cervix and vaginal walls. Since the cervix loses sensitivity after childbirth, when suturing, the woman in labor practically does not feel anything.
But when stitches are placed on the vagina, it's quite tangible, so it's done local anesthesia . Internal sutures are made with self-absorbable threads that do not require additional care and removal of sutures.
To the outer seams carry the seams on the perineum, and here everything is a little more complicated. A woman can tear on her own and the stitches on the breaks heal longer.
However, mostly doctors manage to make a smooth (and absolutely painless) incision towards the anus. Stitches in this place are a little painful, so local anesthesia is also done here.
The stitches in the perineum after childbirth should be especially monitored, because this is a place where you cannot apply a sterile bandage, and the stitches are in contact with external environment and can easily become inflamed.
Self-absorbable sutures
V Lately almost all sutures are superimposed with self-absorbable threads. This is very convenient: they do not need to be removed, and already after 7-10 days there will be no trace of them.
The only thing that a woman can notice is pieces of threads or knots on the pad. Don't be alarmed, know that these remnants of the threads mean that the seams have almost dissolved. A month later, at the examination with a doctor, you can be sure of this.
Let's look at some features
In order for the seams to heal quickly and not become inflamed, they need to be properly looked after. Internal seams in normal flow not processed at all because sterile absorbable sutures are used. There is enough hygienic care.
But if the internal seams are inflamed or festered, then use tampons with levomikol or any other anti-inflammatory ointments.
Special care is needed for the outer seams. They should be processed 2 times a day. In the hospital, this is done by a nurse.
First, the seams are treated with hydrogen peroxide, and then brilliant green or iodine. In addition to this, physiotherapy is carried out to promote speedy healing.
The woman in labor follows through change every 2 hours sanitary napkin , in the maternity hospital use sterile disposable panties. Wash your face at least 2 times a day and after each act of defecation (and do this long after discharge). After washing (potassium permanganate), the seams should be gently blotted with a towel, but, in no case, do not rub it, then treat with peroxide, and then with brilliant green or iodine.
A woman after childbirth always has a lot of trouble. And problems with seams are only a small part of them. But believe, a healthy baby sniffing sweetly in his arms, will atone for all the labors and make you forget about all the difficulties associated with childbirth.
Many women who encounter stitches for the first time after childbirth do not know how to behave properly so that the seams do not come apart.
The most important thing is a woman in labor with stitches should not shrink within 7-10 days in no case. That is, eating, feeding the baby, swaddling and doing other work is possible only in a lying position or standing.
At first it will be difficult to get used to it, and all the time there will be a desire to sit down. It is important not to commit such stupidity, otherwise the seams will open.
It used to be much easier, because the baby was brought only for feeding and immediately taken away, so the woman in labor could rest, get used to her new position. Women in labor with sutures were generally forbidden to get up unnecessarily, which is why the healing of sutures after childbirth was much faster.
But now, when the baby is brought on the first day and left with mom until discharge, observe bed rest quite difficult, because you need to get up and swaddle the baby, wash, feed. Well, how can you not forget and not sit down out of habit?
Remember: it will be possible to sit down no earlier than after 10 days (and this is provided that the sutures heal well without causing complications), and then only for hard chair, and after another 10 days - on an easy chair, bed or sofa.
Since the woman in labor is being discharged for 5-7 days, then the trip home will not be very convenient, the car will have to go in a semi-recumbent position. Warn relatives in advance that only one passenger will be allowed to ride in the car with you, as you will need more space.
There is one more thing: in the first week after suturing, you need to properly go to the toilet "by and large". It is best to give an enema at the first urge, otherwise the seams can also disperse from the tension of the pelvic muscles.
What to do, if…
Seams parted
If the seams are still separated, it is important to determine this quickly.
The internal seams diverge in extremely exceptional cases . It is simply impossible to notice this on your own. This can only be seen by a doctor during an examination. Such seams, as a rule, are no longer touched.
Most often this occurs with external seams in the crotch. Sudden movements, the wrong act of defecation, or if the woman sat down, can cause the stitches to open.
If this happens literally the next day after birth, then repeated sutures are placed. Another conversation, if the edges of the wound have already healed, and the seams have parted. Then the doctor decides on the re-suturing.
If it is only a couple of stitches and there is no threat to life, then the seams can be left as is. But it also happens that the seam came apart fully. Then the edges of the wound are excised, and the sutures are applied again.
While the woman is in the hospital, the doctor examines her every day, and if he finds that the seams are starting to diverge, he will take action. But if after discharge it seems to the young mother that the seams have parted, then you should immediately contact the antenatal clinic, where the gynecologist will tell you what to do after the examination.
The stitches hurt
The stitches may hurt for the first couple of days, then the pain should go away. Internal seams heal much faster, and the pain is felt weakly, passing in a couple of days in general. But the outer seams can disturb for a long time if you do not follow the regimen.
Painful sensations when trying to sit down are quite natural, but if the pain appears in a calm state, this may signal an inflammatory process.
So it is necessary not to endure the pain, but to consult a doctor. If you have time in time, then the inflammatory process is easily eliminated, but if you tighten it, the seams will fester, and it will take a long and tedious time to be treated.
When are stitches removed?
The situation is more complicated with ordinary seams that need to be removed. This can only be done after the wound has healed. Best case scenario it happens on day 6-7.
But if there is inflammation of the sutures after childbirth or the sutures fester, then the healing is delayed and you have to deal with the inflammatory process and only then remove the sutures.
So when are the stitches removed after childbirth? All this is decided individually.. Before discharge from the hospital, the woman is examined by a doctor and, if everything is fine, the stitches are removed (the process is almost painless). If it's too early, the doctor will tell you when to go for a consultation.
During childbirth, situations often arise when it is necessary to put stitches. Their presence requires increased caution from a young mother and, of course, certain skills in caring for this temporary “risk zone”.
When are sutures needed?
If the birth proceeded through the natural birth canal, then the sutures are the result of the restoration of the soft tissues of the cervix, vagina, and perineum. Recall the reasons that could lead to the need for suturing.
Cervical ruptures most often occur in a situation where the cervix has not yet fully opened, and the woman begins to push. The head puts pressure on the cervix, and the latter is torn.
An incision in the perineum may appear for the following reasons:
quick delivery - in this case, the fetal head experiences significant stress, so doctors make it easier for the baby to pass through the perineum: this is necessary in order to reduce the likelihood of injuries to the baby's head;
premature birth - dissection of the perineum pursues the same goals as in a quick birth;
the baby is born in a breech presentation - the tissues of the perineum are dissected so that there are no obstacles at the birth of the head;
with the anatomical features of the woman's perineum (tissues are inelastic or there is a scar after previous births), due to which the baby's head cannot be born normally;
the expectant mother should not push because of severe myopia or for any other reason;
there are signs of a threat of perineal rupture - in this case it is better to make an incision, since the edges of the wound made with scissors grow together better than the edges of the wound formed as a result of a rupture.
If the baby was born by caesarean section, then the young mother has a postoperative suture on the anterior abdominal wall.
Various materials are used for suturing the perineum and anterior abdominal wall. The choice of a doctor depends on the indications, available facilities, the technique adopted in this medical institution, and other circumstances. Thus, synthetic or natural self-absorbable sutures, non-absorbable sutures or metal staples may be used. The last two types of suture materials are removed on the 4-6th day after childbirth.
Now that we have remembered why seams can appear, let's talk about how to care for them. If there is a seam, the young mother should be fully equipped and know how to behave so that the rehabilitation period goes as smoothly as possible, does not leave any unpleasant consequences.
Seams at the crotch
Healing of small wounds and sutures occurs within 2 weeks - 1 month after childbirth, deeper injuries heal much longer. In the postpartum period, all precautions must be observed so that an infection does not develop at the site of the sutures, which can then enter the birth canal. Proper care of an injured perineum will reduce pain and speed up wound healing.
To care for the sutures on the cervix and the walls of the vagina, it is enough only to follow the rules of hygiene, no additional care is required. These sutures are always applied with absorbable material, so they are not removed.
In the maternity hospital, the sutures on the perineum are processed by the midwife of the department 1-2 times a day. To do this, she uses "brilliant green" or a concentrated solution of "potassium permanganate".
The stitches on the perineum, as a rule, are also applied with absorbable threads. The nodules fall off on the 3rd-4th day - on the last day of stay in the hospital or in the first days at home. If the suture was applied with a non-absorbable material, then the sutures are also removed on the 3-4th day.
In the care of the seams on the perineum, personal hygiene also plays an important role. Every two hours, you need to change the pad or diaper, regardless of its filling. It is necessary to use only loose cotton underwear or special disposable panties.
It is also necessary to wash yourself every two hours (after each visit to the toilet; you need to go to the toilet exactly at such a frequency that the filled bladder does not interfere with uterine contraction).
In the morning and evening, when you take a shower, the perineum should be washed with soap, and during the day you can simply wash it with water. It is necessary to wash the seam on the perineum thoroughly enough - you can simply direct a jet of water at it. After washing, you need to dry the perineum and the seam area by blotting the towel from front to back.
If there are stitches on the perineum, a woman is not allowed to sit down for 7-14 days (depending on the degree of damage). At the same time, you can sit on the toilet already on the first day after childbirth. By the way, about the toilet, Many women are afraid of severe pain and try to skip bowel movements, as a result, the load on the muscles of the perineum increases and the pain intensifies.
As a rule, in the first day or two after childbirth, there is no stool due to the fact that before childbirth the woman was given a cleansing enema, and during childbirth the woman in labor does not take food. The chair appears on the 2-3rd day. To avoid constipation after childbirth, do not eat foods that have a fixing effect. If the problem of constipation is not new to you, drink a tablespoon of vegetable oil before each meal. The stool will be soft and will not affect the healing process of the stitches.
In the vast majority of cases, it is recommended to sit down on the 5-7th day after childbirth - on the buttock, opposite to the side of the injury. You need to sit on a hard surface. On the 10-14th day, you can sit on both buttocks. The presence of stitches on the perineum must be taken into account when traveling home from the maternity hospital: it will be convenient for a young mother to lie or half-sitting in the back seat of the car. It is good if the baby at the same time comfortably settles in his personal car seat and does not occupy his mother's hands.
It happens that the scars remaining after the healing of the sutures still cause discomfort and pain. They can be treated with warming, but not earlier than two weeks after birth, when the uterus has already contracted. To do this, use "blue", infrared or quartz lamps. The procedure should be carried out for 5-10 minutes from a distance of at least 50 cm, but if a woman has sensitive white skin, it should be increased to a meter to avoid burns. This procedure can be done independently at home after consulting a doctor or in the physiotherapy room.
If a woman feels discomfort at the site of the formed scar, the scar is rough, then the doctor may recommend Contractubex ointment to eliminate these phenomena - it should be applied 2 times a day for several weeks. With the help of this ointment, it will be possible to achieve a decrease in the volume of scar tissue formed, to reduce discomfort in the scar area.
Stitches after caesarean section
After a caesarean section, the sutures are observed especially carefully. Within 5-7 days after the operation (before removing the sutures or staples), the procedural nurse of the postpartum department daily treats the postoperative suture with antiseptic solutions (for example, "brilliant green") and changes the bandage.
On the 5-7th day, the sutures and the bandage are removed. If the wound was sutured with absorbable suture material (such material is used when applying the so-called cosmetic suture), then the wound is treated in the same mode, but the sutures are removed (such threads are completely absorbed on the 65-80th day after the operation).
The skin scar is formed approximately on the 7th day after the operation; therefore, already a week after a caesarean section, you can safely take a shower. Just do not rub the seam with a washcloth - this can only be done in a week.
A caesarean section is a rather serious surgical intervention in which the incision passes through all layers of the anterior abdominal wall. Therefore, of course, the young mother is worried about pain in the area of surgical intervention.
In the first 2-3 days, painkillers, which are administered intramuscularly to a woman, help to cope with painful sensations. But already from the first days, to reduce pain, the mother is recommended to wear a special postpartum bandage or tie up her stomach with a diaper.
After a caesarean section, young mothers often have a question: will the seam open if you take the baby in your arms? Indeed, after abdominal operations, surgeons do not allow their patients to lift more than 2 kg for 2 months. But how to say this to a woman who has to take care of a baby? Therefore, obstetricians do not recommend that parents after a cesarean section during the first time (2-3 months) lift more than 3-4 kg, that is, more than the weight of the child.
Possible Complications
If pain, redness occurs in the area of the seam on the perineum or anterior abdominal wall, discharge from the wound appears: bloody, purulent or any other, then this indicates the occurrence of inflammatory complications - suppuration of the sutures or divergence. In this case, you must consult a doctor.
Depending on the severity of the condition, the doctor will prescribe a local treatment for the woman. In the presence of purulent-inflammatory complications, this can be Vishnevsky's ointment or Synthomycin emulsion (they are used for several days), then, when the wound is cleared of pus and begins to heal, Levomekol is prescribed, which promotes wound healing.
Once again, I would like to emphasize that the treatment of complications should take place only under the guidance of a doctor. It is possible that a midwife will come to the patient's home to process the stitches, or maybe the young mother herself will have to go to the antenatal clinic, where they will carry out the procedure.
Suture Healing Exercises
To speed up the healing process, whenever possible, you should try to strain your muscles. pelvic floor to increase blood flow. As an example of such an exercise: contract the muscles around the vagina in an upward and inward direction, as if you need to stop the flow of urine. Maintain this position for a count of 6. Relax. Such exercises can be repeated several times a day, alternating tension and relaxation 5-8 times.
During childbirth, it may be necessary to incise the perineum or, in the worst case, tear the vagina or cervix. Then obstetrician-gynecologists sew up the damaged tissue. Stitches can cause pain and inconvenience to a new mother, and when improper care and disdain for physical limitations completely disperse, which will entail undesirable consequences.
Types of postpartum sutures
If the incision is made towards the anus, the incision procedure is called a perineotomy. Stitches after childbirth are applied when soft tissues are damaged for their speedy healing and prevention of undesirable consequences (suppuration, inflammation, and others). At natural childbirth the walls of the uterus, cervix, vagina can rupture. Often, doctors specifically cut the perineum to facilitate the process of removing the fetus and prevent ruptures, because the incision heals faster and less often leads to complications. If the mother had surgery C-section, then the uterine wall, intramuscular tissue and skin on the abdomen are sutured. Let us consider in more detail the types of postpartum sutures during natural childbirth:
- Stitches on the cervix. They are superimposed when tissues are ruptured due to insufficient disclosure of the cervix. The cervix is sutured "on the live" immediately after childbirth. Anesthesia is not required due to partial loss of organ sensitivity during childbirth. Most often, self-absorbable material is used, the threads do not require subsequent removal and specific care in postpartum period.
- Stitches in the vagina. Causes of vaginal rupture - lack of elasticity or physiological features. When stitching, local anesthesia or general anesthesia is used for a short time, since the sensations during the procedure are painful.
- Seams at the crotch. The most common type of tear is in the perineum. There are three degrees of rupture, depending on the location of the damage. The first degree is called a rupture of the skin, the second - the skin and muscles, the third - a violation of the integrity of the skin, muscles of the rectum. To prevent the formation of a tear with jagged edges that take a long time to heal, doctors may make an incision in the perineum with a scalpel. When dissecting the perineum from the center to the anus, the perineotomy method is used. An incision from the posterior commissure at a 45 degree angle is called an episiotomy. The suturing occurs in stages - first, the walls of the rectum are fixed with a thread, if it is damaged, then the muscle tissue, and lastly, the skin. The last layer is sewn together with synthetic threads impregnated with antibiotic solutions. A few days later, the doctor removes them.
Breaks most often occur for the following reasons:
- large fruit;
- incorrect presentation of the fetus;
- mother's age over 35;
- narrow pelvis of the woman in labor;
- rapid childbirth;
- the presence of scars on the perineum from previous births;
- features of the structure of the perineum and others.
Why do the seams on the perineum diverge after childbirth
Absorbable materials or sutures may be used for suturing, requiring removal. Sutures made of non-absorbable materials are usually removed 5-7 days after delivery in the maternity hospital or antenatal clinic. The procedure is usually painless, rather a little uncomfortable. Unlike internal sutures in the uterus or vagina, they are more likely to become inflamed in the perineum due to constant contact with lochia ( postpartum discharge) and physical activity young mother. We list the most common causes of divergence of seams after childbirth:
- non-compliance with bed rest in the first days after childbirth;
- premature seating;
- lifting weights and sudden movements;
- constipation, which provokes pressure on damaged tissues;
- wound infection;
- insufficient hygiene of the genitals;
- wearing tight underwear made from non-natural fabrics;
- sexual life before the healing of the sutures.
Reapply
The internal seams diverge extremely rarely, unlike the stitches on the perineum, since the muscles on the cervix and in the vagina are less mobile and are not subject to mechanical damage. However, this can happen with premature intercourse, for example. If, upon self-examination, you find that the seam looks suspicious, delivers severe pain while walking, you must urgently contact a gynecologist at the antenatal clinic or at the maternity hospital from where you were discharged. It is possible to reliably establish the divergence of the seam only when examined on a doctor's chair. It is advisable to contact an obstetrician-gynecologist who took delivery and is well acquainted with the anamnesis in order to perform the necessary surgical procedures as soon as possible, re-suturing, if necessary.
If the wound has healed and the suture looks solid, but there are small areas of inflammation, the doctor may prescribe antibiotic therapy- treatment with antiseptic solutions, anti-inflammatory ointments or application rectal suppositories at internal injuries. Another thing is if the wound is still fresh, and the seams are already diverging. In this case, it is usually assigned reoperation for suturing. If this happened while still in the hospital, the doctor will notice the failure of the suture during the examination and re-sew as soon as possible. Local anesthesia is used and pain is practically absent. The procedure for suturing is similar to the initial suturing after childbirth. The operation takes only about half an hour. After the procedure, standard measures are prescribed to prevent the divergence of the seam and means for disinfection and the speedy healing of the wound.
In a situation where a complete or partial divergence of the seam has already occurred at home, the tissues can become inflamed due to infection in the opened wound. A second dissection is necessary with the possible partial removal of inflamed areas and suppuration. The woman is under general or local anesthesia pain is usually absent. The wound is first thoroughly washed with antiseptics, and then again dissected and sutured in a hospital using standard materials and postpartum suture techniques. The patient is advised to remain in the hospital under medical supervision for 5-6 days until the sutures are removed if a non-absorbable material is used. On the recommendation of a doctor, in addition to standard suture care, antibiotics may be prescribed to prevent development inflammatory process. Pain after all the manipulations, they can be quite intense with a complete dissection of the suture or insignificant, with partial divergence and no complications after the operation.
The appearance of the suture subsequently depends on the quality of the work of surgeons and the individual characteristics of the skin, but in most cases, repeated suturing leads to the formation of a denser scar than with a single procedure. The period of complete healing is from 2 weeks to 2 months and depends on the individual characteristics of the skin, as well as the presence or absence of inflammation after suturing.
Signs of seam divergence
Most often, the seam begins to diverge at the end of the incision. Internal seams diverge quite rarely. This can happen if the body rejects the suture material with individual intolerance to its components. The divergence of the external seams on the perineum occurs more often, usually within a few days after the removal of the threads. A woman may feel discomfort in this area, notice suspicious discharge. If you suspect something is wrong, examine the genitals with a mirror. If the outer seam does not bleed or look inflamed, the most likely cause of concern is gynecological problems or failure of internal postpartum sutures. We list the signs of a divergence of the outer seam, which should alert the young mother:
- changes in color and texture vaginal discharge- the appearance of blood or purulent inclusions;
- redness and swelling of the genitals;
- increase in body temperature;
- burning at the site of the wound;
- sharp pain in the perineum, aggravated by movement.
Therapy after re-suturing
After suturing, you can not do without the use antiseptic preparations, which treat the wound until it is completely healed 1-2 times a day. These include:
- green;
- potassium permanganate solution;
- furacilin solution;
- Chlorhexidine;
- hydrogen peroxide;
- Miramistin;
- medical alcohol.
With the development of complications, slow healing of sutures, or after they are re-applied, the doctor may prescribe a course of treatment with the use of anti-inflammatory drugs. Therapeutic composition impregnate a gauze pad and fix with underwear or a plaster, in contact with the crotch. At internal seams a tampon lubricated with medicine is inserted into the vagina. Change pads or tampons 1-2 times a day in accordance with the instructions of the doctor. Commonly prescribed medications include:
- Ointment Levomekol. Designed for processing festering wounds. The duration of treatment is determined individually and lasts until the cessation of pus discharge. During lactation, the drug is contraindicated. The ointment is considered highly effective, the result is usually noticeable within a few days after the start of use. The price of the drug is about 150 rubles.
- Ointment Vishnevsky (Liniment balsamic). The specific smell of this ointment has been familiar to many since childhood - in the Soviet past, it was used as an external anti-inflammatory agent everywhere. The drug is considered quite effective and today, does not give up its positions, despite the active development of pharmacology. As part of the components of natural origin, providing a characteristic smell - tar, Castor oil, xeroform. The drug is considered one of the safest, has no side effects and is contraindicated only in case of individual intolerance to the components. The price of the ointment is also loyal - about 30-50 rubles.
- gel and ointment Solcoseryl. One of the most modern means for the treatment of postpartum and other types of sutures. Active substance of natural origin, obtained by chemical processing of the blood of calves. It is used to treat wounds without purulent discharge, suitable for treating sutures with signs of inflammation, swelling, redness. Side effects not identified, a contraindication is an allergy to the components of the product. The duration of treatment is determined individually. The price of the drug is 400–450 rubles.
Photo gallery: means for processing and healing
Solcoseryl gel is suitable for eliminating redness, swelling of the seams. A solution of brilliant green is popularly called green. In maternity hospitals, the seams are treated with solutions of potassium permanganate, furacilin, Chlorhexidine, hydrogen peroxide. Levomekol ointment is used to treat purulent wounds. analogues
Reviews of women
sewed. the seam is not very large. sold out, because they brought the infection and for a long time they did not pay attention to my complaints. I turned to another maternity hospital (because there was no longer any confidence in this. And I did the right thing) it turned out that everything was very neglected. a “pocket” was formed with a large amount of pus (already!). first cured this bug. treated for 1.5 months. then the stitches were reattached. but alas. Actually, it's my own fault. I had to take care of myself and not lift anything heavier than a mug of tea. I decided to walk with the baby in the stroller. Well, I let them down from the fourth, without an elevator, but when I lifted them, I tensed up. Didn't go for a third stitch. and now it’s only plastic, but I’ve been ill and now I don’t have a complex in my mind.
unpleasant to me
https://eva.ru/static/forums/153/2006_3/595985.html
No need to sew! And no one will sew you up, when I saw I had even more, cm 3 the seams parted, I went to the doctor, she prescribed the treatment and I did everything and everything grew together by itself
Alexa
I had it! The seam parted with the first child, went to the gynecologist, she again cut off the walls (so that they would grow together well) and sewed them up again ... After the second, the seam also parted, but not much (I just had cracks), I didn’t go anywhere and so it healed ...
ツॐइॐºLoveลshkลツॐइॐº
https://www.baby.ru/popular/razoselsa-sov-na-promeznosti/
Tips for altering do not roll, the doctor decides. And it is not always possible to immediately sew up again, the edges should be treated. I also experienced a similar situation, the doctor advised chlorhexidine to douche, dry, then apply Solcoseryl GEL (4 times a day) for 5 days. After epithelization, apply Solcoseryl ointment. And after defects can be honed with a laser or a cosmetic method! Be healthy!
Alexandra
I was re-darned 3 months after giving birth ... before that I smeared 4 times a day with levomekol, baneocin, then methylurocil and inserted iodine suppositories (I don’t remember the name) ... they made a cosmetic seam ... after 10 days with sutures they were allowed to sit.
VER4EVI4
https://www.babyblog.ru/community/post/vosstanovlenie/1697328
well, it’s true that one seam came apart, I smeared it with levomikol, it didn’t grow together perfectly, but the gynecologist said that she didn’t see the point in plastic surgery, because. still spasmodic.
Natalia Milova
https://www.babyblog.ru/community/post/vosstanovlenie/1697328
And I remembered about the seams for a whole month! Until the threads fell off! Because of them, everything hurt terribly (it was painfully tight or something). I washed it with potassium permanganate and then with chamomile, and smeared it with D-panthenol and some other healing ones. But how the threads fell off - the pain disappeared like a hand!
https://forum.materinstvo.ru/lofiversion/index.php/t26195–250.html
Prevention measures
So that the seams do not come apart in the first days after childbirth, a woman is recommended bed rest. After childbirth, a woman must follow special hygiene rules and a number of recommendations so as not to provoke a divergence of the seams in the perineum. It is important to limit motor activity, regularly treat wounds with antiseptics, avoid squats. To minimize the risk of complications, follow these guidelines:
- on the first day after childbirth, you can only lie down;
- from the second day it is permissible to walk and stand;
- sitting is allowed no earlier than 1-2 weeks after childbirth on a hard surface in the absence of pain;
- the baby should be fed in the supine position;
- underwear should not be tight, made of natural breathable materials;
- begin sexual activity no earlier than 6 weeks after childbirth;
- it is necessary to wash daily with the use of baby soap;
- wipe the perineum with blotting movements with a clean cotton towel;
- treat the wound with antiseptics and ointments as prescribed by the doctor regularly;
- use postpartum pads until lochia stops, change them every 2-3 hours;
- food should be dietary, preventing the development of constipation;
- soften if necessary stool glycerin suppositories;
- Do not lift loads that are heavier than the weight of the child.
The ban on sitting down requires special attention. A woman is allowed to half-squat on the toilet from the first day. In other cases, she can only lie or stand. After about 1-2 weeks, it is allowed to take a reclining position. Then you can try to sit on a hard chair. Only after the stitches have completely healed, it is permissible to sit on soft surfaces - on a bed, sofa, pillow.
Possible negative consequences and complications
Pain, physical discomfort, development of infections - possible complications after seam separation When ignoring the signs of divergence of the seam, the woman feels pain and discomfort, runs the risk of infecting the wound. In the future, such a seam will look unaesthetic, the skin may be deformed, and the situation can be corrected only with the help of plastic surgery. In the postpartum period, you need to carefully monitor your well-being and appearance seam. We list the possible Negative consequences from split seams.
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