When sutures dissolve after childbirth. The suture does not heal after surgery, what to do?

The birth of a new life is always accompanied by pain. Knowing this, expectant mothers await childbirth with bated breath - who knows how everything will go? Fortunately, the great joy of meeting a long-awaited baby immediately displaces all negative moments from memory. The young mother will be reminded of the birth by internal stitches for some time. Read the article about where they come from and what to do with them.

When the period of intrauterine life expires and the baby is ready to leave its warm shelter, the so-called labor begins, in which the uterus, its cervix, vagina and perineum take a direct part. As the baby's head moves forward, all these organs experience strong pressure. This is the main reason (and there are many more indirect ones) of the probable rupture of the tissues of the internal genital organs. Depending on the location, internal injuries can vary in severity.

Uterine rupture is a dangerous complication that threatens the life of a woman in labor. If the labor progresses satisfactorily, the uterus remains intact, because its muscles are strong enough to withstand the load that the baby’s head imparts to them. In modern medical practice, such cases are extremely rare, since doctors anticipate the danger and perform a planned or emergency caesarean section.

When the perineum is damaged during childbirth, it is called an external rupture. The treatment tactics in this case are slightly different from the treatment of internal sutures: the perineum is sutured with a material that does not dissolve (silk, polypropylene). After tissue fusion, the suture material is removed.

And today we will pay attention to ruptures of the cervix and vagina - it is these injuries that are sutured with internal sutures during childbirth. In this case, special materials are used - after some time after use, they dissolve on their own.

Cervical rupture is most often the result of premature pushing during natural childbirth. The cervix cannot relax and open very quickly, and if a woman rushes out, pushing out the baby, tissue damage occurs. Full dilatation requires an average of 10–12 hours (this may happen faster in multiparous women). Not a single woman in labor has managed to avoid premature labor, but they must be restrained with all our might until the doctor gives the go-ahead. You can push only after the cervix is fully dilated. For the same reason, due to the strong pressure of the baby’s head, the vaginal walls also tear.

Reasons for the formation of internal tears during childbirth

During the process of childbirth, there are always factors that in one way or another affect the condition of the muscles of the internal organs, which are affected by labor, to the point that they may rupture. Most often, internal damage of this nature occurs for several reasons:

large size of the fetus;
insufficient elasticity of tissues;
sudden onset of labor (rapid labor);
too narrow vagina (anatomical feature);
development of an inflammatory reaction in the vaginal area during pregnancy;
childbirth after intentional termination of pregnancy in the past.

Diagnosis and treatment of internal ruptures after childbirth

Immediately after the baby is born, it is difficult to determine whether a woman has internal tears. To check this, the doctor uses speculum to examine the cervix and vaginal walls as soon as the placenta is released. Please note that everything is sutured, even the most minor cracks and wounds. Areas damaged during childbirth may become inflamed after some time. Thus, they will become a source of suppuration and infection, and this is the last thing a new mother needs with a baby in her arms.

The procedure for suturing tears in the cervix is unpleasant, but generally does not cause pain, since this area is devoid of receptors that react to mechanical intervention with negative sensations. Anesthesia is of no use in this case.

Stitching the vaginal walls, on the contrary, is a rather painful procedure, since the tissues in this place have a large number of nerve endings. To help a woman undergo such a surgical procedure, anesthesia is given using painkillers Lidocaine or Novocaine.

Are internal stitches removed after childbirth?

To suturing internal injuries, doctors use a special suture material, which dissolves without a trace after some time after suturing, without causing the slightest harm to the woman’s body.

In most cases, this is catgut - strong natural threads obtained by processing sheep intestines. The structure of the material is as close as possible to the tissues of the human body, therefore it is easily absorbed 7 – 10 days after suturing. The process is initiated by the woman's enzymatic system.

Also, seams can be made with half synthetic threads: vicryl, PHA, caproag. They take longer to dissolve - complete dissolution can take from 30 to 60 days.

How to care for internal stitches after childbirth

Postoperative sutures of this kind are “good” in that they do not require any action from the woman herself. The body itself, without the participation of the young mother, will decide how long the internal sutures will dissolve after childbirth. No symptomatic treatment in the form of ointments or tablets is needed. But it is still important to know some medical recommendations on this matter.

In the first weeks after the birth of the baby, lochia is released from the uterus - dense bloody clots, due to which sterility in the area of the internal sutures is excluded. There is also no opportunity to apply a sterile bandage to the stitched area, so the woman must carefully monitor the slightest changes in her well-being during this period.

Previously, the attitude towards a postpartum woman with internal ruptures was special. The presence of internal stitches required the woman to lie down for several days after giving birth, and the baby was brought to her for feeding only on the third day. Today the situation has changed radically: it is believed that the recovery period, when the internal sutures heal after childbirth, will go faster if the mother returns to an active lifestyle as early as possible. That is why postpartum management of patients who have internal sutures is no different from the management of absolutely healthy women.

In order for the young mother to focus less on the symptoms of postpartum illness, the newborn baby is given to her immediately - they lie together in the ward. However, the help of medical workers or the patient’s relatives will be needed in any case, because because of the internal stitches you need to lie down for about 2 – 3 days. Concerned mothers always ask the doctor whether internal stitches can come apart after childbirth. This risk exists, so at first you need to take care not only of the baby, but also take care of yourself. Practice shows that the recovery period is successful if the postpartum woman listens to the advice of doctors, gets plenty of rest and eats well.

To prevent the internal suture from splitting and festering after childbirth, you need to remember some precautions:

If there are many breaks and they are very deep, the woman is prescribed a course of antibiotic therapy to eliminate the risk of suppuration. You cannot refuse treatment, despite the fact that the issue of breastfeeding will have to be postponed for some time.
It is not recommended to sit upright in the first month after childbirth; it is better to try to sit down carefully in a reclining position or to transfer the entire body weight not on two buttocks, but on one of them. All body movements must be measured and smooth. The possibility of resuming sports training can be discussed with your doctor no earlier than 1 to 2 months after suturing.
You can give your baby breastfeeding only in a lying position; it is recommended to eat by yourself either standing or also lying down.
You will have to forget about such a burning topic as sex after childbirth if you have internal stitches for a while. You need to wait 1.5 - 2 months so that the torn walls of the cervix and vagina have the opportunity to reliably heal and restore natural elasticity. Only after this can you resume intimate relationships with your loved one. Otherwise, sexual contact becomes an excellent reason for infection of fresh sutures and provokes their suppuration, which, in principle, is very dangerous.
For the first time after suturing, you should not lift heavy objects. “Heaviness” also means the baby, especially if he is big.
One of the most important conditions for the successful healing of injured tissue is personal hygiene. And, despite the fact that this is obvious to a woman, the doctor always draws her attention to the need for strict sanitation of the external genitalia and the entire body. While the recovery process lasts, you will have to forget about the bath and limit yourself to showering 1-2 times a day. It is better not to wear panties immediately after water procedures. An excellent option is special disposable underwear, which can replace regular underwear for a while.
A young mother should first have postpartum pads in her arsenal of skin care products, and then regular panty liners. If possible, they need to be replaced very often - this is the only way to ensure dry conditions for the stitched areas.
It is not advisable to wear shapewear underwear for 1.5 - 2 months after suturing. The hard, dense tissue puts strong pressure on the perineum and vagina, which prevents the natural regeneration of internal tears.

Lifestyle with internal stitches after childbirth

All processes of the female body after the birth of the baby are aimed at the formation, maintenance and preservation of lactation. Due to such dramatic metamorphoses, a woman may suffer from constipation. The diet prescribed to all postpartum women without exception is especially relevant for mothers whose childbirth ended with internal sutures. The reason is clear - with constipation, the overcrowded intestines put pressure on the fresh sutures, and this is dangerous due to their divergence. If there has been no stool for 1-2 days, you need to take a laxative or dare to have an enema, even if, at first glance, nothing bothers you. After emptying, be sure to wash yourself with running warm water to eliminate the possibility of infection. The mother's diet should be focused on the consumption of broths and various liquids.

Complications with internal sutures after childbirth

If a woman notices the appearance of certain alarming symptoms, there is a reason to seek help from an antenatal clinic. Symptoms may include:

Internal seams hurt and itch after childbirth. The discomfort is constant, even when the woman is lying down;
there is a feeling of heaviness in the lower abdomen;
body temperature suddenly rises;
pus comes out of the genital tract.

The listed symptoms are eloquent signs of inflammation or divergence of internal seams.

However, even in the absence of painful sensations, you need to find time to see a gynecologist in any case. Immediately after childbirth and suturing, the doctor cannot fully evaluate the results of his work due to extensive internal tissue swelling. The specialist will do this a little later, during the patient’s recovery process.

Particular attention is paid to the condition of the cervix, which, as the wounds heal, should take on a look close to pre-pregnancy. In case of rough scarring or incorrect fusion of the sutures, the woman will face problems in the future. They may be as follows:

miscarriage;
incomplete dilation of the cervix during the next birth.

The situation can be corrected by resorting to a second operation: the old scar will be incised and new stitches will be placed. In order to timely assess the condition of the internal genital organs after ruptures, you should consult a doctor no later than 1 - 1.5 months after the birth of the child.

When delivering a baby vaginally, doctors sometimes have to resort to perineotomy or episiotomy - cutting tissue from the opening of the vagina back towards the rectum or at an angle to the midline. Sutures in the perineum after childbirth require special attention from doctors and the young mother’s compliance with certain recommendations.

Read in this article

Why do they need stitches?

Perineotomy is an operation that protects the mother and helps the baby to be born. In the second stage of labor, excessive stretching of the perineal tissue may occur, and there is a threat of its rupture. This happens in the following cases:

high crotch;
inflexibility of tissues in women giving birth for the first time after 30 years;
scars from previous births;
the position of the child during childbirth, when he faces the perineum with his forehead or face (extensor presentation);
use of obstetric forceps or vacuum extraction of the fetus;
large fruit;
rapid labor;
premature eruption of the head due to improper management of labor by a midwife.

A cut with straight edges heals better than a tear. Therefore, a dissection of the perineum is performed, followed by suturing after the birth of the child. The wound is sutured to speed up its healing.

Precautions in behavior after the incision

The length of the tissue dissection is about 2–3 cm; after suturing, the incision heals quickly. To prevent this process from slowing down and becoming more complicated, a young mother should take some precautions:

on the first day after birth you should only lie down;
standing and walking are allowed from the second day, for example, a woman must eat at a special high table, which is in the dining room of the maternity hospital;
you can sit only 3 days after the stitches are removed or 2 weeks after giving birth, first on chairs and then on a soft bed or sofa;
The newborn should be fed while lying on the bed;
properly care for the perineum;
avoid constipation;
wear cotton, non-tight underwear.

When are stitches removed after childbirth? This usually happens a week or less after the baby is born. Thus, a woman should be careful in the first 14 days of the postpartum period.

If the sutures are applied using self-absorbing material, then they do not need to be removed. The woman is discharged home at the usual time; the synthetic threads in the incision area completely disappear after a few weeks. The nodules disappear within 2 weeks after birth.

Proper care of intimate areas and stitches

How to treat sutures on the perineum after childbirth? The use of special antiseptics is not required. After visiting the toilet, a woman should wash herself with warm boiled water from the perineum to the anus and dry the skin with a clean cloth or paper towel. After washing, it is recommended to lie on the bed for a while without a pad so that the seam area dries well.

It is also necessary to change postpartum pads at least every 2 hours to prevent infection.

If you follow these simple tips, an incision in the perineum is not dangerous. After it, only a small scar remains. If a cosmetic suture was applied, then traces of it are practically invisible.

The use of medications to care for sutures is required if healing is slow or complications develop. A doctor must prescribe these medications. Usually they use treatment with chlorhexidine, hydrogen peroxide, less often they recommend ointments - “Levomekol”, “Vishnevsky Ointment”, “Solcoseryl”, products with panthenol.

Exercises for speedy recovery

To speed up tissue restoration, you can perform special gymnastics. It should be remembered that before the sutures are removed, you cannot perform exercises with abduction (breeding) of the legs.

In the first two days, the exercises are performed while lying in bed. They include bending the legs at the ankle joints, and then at the knees. Subsequently, lifting the pelvis with support on bent legs is added. Breathing exercises are also useful. Class duration is 15 minutes.

On subsequent days, gymnastics is performed standing and its duration increases to 20 minutes. Turns and shallow bends of the body, standing on tiptoes, and light squats are added. Periodic contraction of the anal sphincter throughout the day and attempts to temporarily stop the flow of urine during urination are indicated. Such exercises help restore blood supply to tissues and speed up healing.

Causes of seam divergence

Some women still experience suture dehiscence after suturing the perineal incision. The reason for this is the woman’s failure to comply with the recommendations for the regimen:

getting out of bed early;
sitting for a long time during the first week after birth;
incorrectly performed exercises during gymnastics.

In addition, the sutures also come apart if the postoperative wound becomes infected.

Symptoms that should alert you

If a woman has pain in her stitches after childbirth, she should tell her doctor. This is one of the main symptoms of a wound not healing. In addition, signs of trouble may include:

bleeding from the incision;
feeling of fullness in the perineum;
tissue swelling;
fever, chills, weakness;
purulent discharge;
formations under the skin in the form of tubercles or bumps.

In all these situations, it is necessary to contact an antenatal clinic. Otherwise, the sutures will hurt for a very long time, and after the wound heals, deformation of the walls of the vagina and perineum will remain.

Methods for correcting abnormal skin fusion

The perineum is usually sutured with two rows of sutures: the first is placed on the muscles, and the second on the skin. If only the superficial suture has come apart, measures are taken to prevent infection (treatment with chlorhexidine, hydrogen peroxide, brilliant green and other antiseptics); re-suturing is not performed.

If a woman’s entire stitch really comes apart, the cause is usually purulent inflammation. In this case, severe pain, fever, and purulent discharge occur. In this case, you need to urgently consult a doctor; surgical treatment of the wound will probably be required.

In case of significant deformation remaining after a deep seam has opened, it is further indicated.

So, sutures are placed on the perineum after childbirth to speed up the healing of the tissue incision. If the rules of care are followed and a woman is careful about her health, her well-being quickly returns to normal. If disturbing symptoms appear, you should seek help from a gynecologist.

The main question of interest to those women who have had stitches after childbirth concerns how long they take to heal. Let's try to figure it out and talk about how long it takes for sutures to completely heal, depending on their type.

What types of sutures are used after the end of labor?

In order to understand how long it takes for sutures to heal after the birth process, it must be said that there are external and internal. The first type includes those that are superimposed on the perineal area, the rupture of which often occurs when the size of the birth canal does not correspond to the size of the fetus. Moreover, in some cases, in order to prevent spontaneous bleeding, doctors make a small incision using medical instruments. The thing is that this kind of wound heals much faster than a lacerated one. The procedure in which suturing of perineal tears is performed is called

Internal sutures are much more common. Such manipulation is mandatory in cases where there is a rupture of the vaginal walls, or a tear in the uterine cervix. In this case, self-absorbable suture material is used.

How long does it take for a stitch to heal?

When talking about how long it takes for internal sutures to heal (dissolve) after childbirth, doctors usually call the period 5-7 days. This is exactly how long it takes for the material used to apply internal sutures to completely disappear. However, this does not mean that the wound has completely healed.

External sutures after childbirth heal in about 10 days. However, due to the fact that they are more exposed to environmental factors, this process can take up to 1 month. In some cases, if sterility is not observed during application or due to poor suture treatment, the wound may become infected, which only prolongs the regeneration process.

What nuances should a woman in labor observe to avoid complications?

It is very important in the postpartum period to pay attention to the correct and timely treatment of sutures.

So, doctors recommend performing this manipulation at least 2 times a day. In a medical facility, this is done by nurses. In addition, to avoid infection, a woman should change her sanitary pad every 2 hours. If you suddenly notice traces of blood on your underwear, you should inform your doctor.

Also, young mothers are often interested in the question of how much stitches placed after childbirth hurt, and how long a woman with stitches cannot sit. As a rule, pain subsides within 3-4 days. Doctors also prohibit a woman from sitting for 10 days; she can only sit on one buttock and for a short time.

External sutures after childbirth are removed when 10-14 days have passed since their application. At the same time, scars remain in their place in most cases.

A surgical operation that involves an incision of soft tissue necessarily has consequences for the patient in the form of a period of healing of the postoperative scar. This process, in turn, is usually divided in medicine into several main stages, which occur sequentially one after another.

The first of them is the formation of collagen in the cut tissues, which serves to connect the cut. This substance forms a special connective tissue, which can subsequently be clearly distinguished on. Moreover, it is the collagen phase that determines the strength of such a connection. After passing this phase, which usually lasts 3-5 days, a period of scar epithelization begins, during which healthy skin cells form on its surface. Until this process is completed, the surface of the wound remains vulnerable to bacteria, so it must be kept clean and prevent infections from entering the wound. This healing phase typically takes 5 to 10 days, depending on the nature of the incision.

Finally, the third phase of healing is the reduction of collagen in the damaged tissue and closure of the wound. At this stage, the shape of the scar is finally determined, as well as the disappearance of the primary symptoms characteristic of serious damage - swelling and severe redness. In general, the primary process of scar formation, which includes the three listed phases, usually takes about three weeks, but doctors usually recommend that the patient avoid intense exercise and protect the scar site for another 1-2 months.

Final formation of the scar

In addition, it should be remembered that during this period the scar has not yet acquired its final appearance, which it will have for the rest of its life. Gradually, further compaction of the scar tissue will occur, as well as an even out of the color of the skin covering the scar. Thus, the scar will take on its final appearance approximately 1-1.5 years after the operation.

Moreover, the entire healing process, both at the primary and secondary stages, can have varying lengths, depending on the specific characteristics of the patient. Thus, it has been proven that scars heal more slowly in older people, in people who are overweight, as well as in those who have a generally weakened state of the body due to disorders of the immune system, poor nutrition, chronic diseases or other reasons.

The patient is not always given recommendations on how to treat the postoperative suture for better healing. Modern means are presented in a wide variety, the main thing is not to make a mistake with the choice. Products that are identical in purpose may not be suitable in different situations. The patient should know in which case to use one or another method of therapy.

Why is it important to properly handle the suture after surgery?

The attending doctor should provide information about further manipulations, but, unfortunately, this does not always happen in modern clinics and hospitals. The patient returns home after long-term therapy and does not know how to properly treat the postoperative suture for better healing. Correct tactics are important for quick and rapid healing. Surgeons focus on home treatment of sutures; they become a common cause of complications.

If redness, swelling forms at the site of the postoperative suture, blood, pus, bile, etc. are released, you should immediately seek help from a doctor, this indicates a complication. It is necessary to carefully monitor the condition of the wound after surgery.

Proper wound treatment is important for the following reasons:

to avoid serious complications that could lead to repeat surgery;
to maintain the sterility of the wound to prevent suppuration and infection;
for a speedy recovery;
to prevent pain;
to avoid the inflammatory process.

If a person correctly performs the manipulations to treat the seam, recovery occurs on average after 2 weeks. It all depends on the type of operation, severity, and type of suture.

How does rapid healing occur?

Wound healing occurs differently in each patient, depending on the type of suture and the severity of the surgical intervention performed. You should never leave a wound untreated. Treatment is needed to ensure a quick recovery and the stitch to heal without complications.

Ointments and other medications with antiseptic, anti-inflammatory, and regenerating effects help to quickly get rid of the unpleasant consequences after skin surgery. They are necessary in order to:

rapid tissue regeneration occurred (recovery, wound closure);
no inflammatory process occurred due to antibacterial and antiseptic properties;
improve the quality of newly formed tissue;
reduce internal intoxication.

Healing occurs in several stages, they are clearly visible during processing manipulations. Firstly, the wound is disinfected, which promotes healing; bacteria cannot prevent the wound from healing. Secondly, the ointments and creams used help speed up regeneration, that is, help the skin recover and improve the quality of the new tissue being formed.

Taken together, all actions lead to the fact that the seam heals soon.

Treatment - how to speed up the healing of postoperative sutures with ointments and other means

At the initial stage, each operated patient should understand the stages of suture treatment in order to understand when it is necessary to perform the necessary actions (apply ointment, clean the wound, etc.).

Seam processing at home is performed as follows:

carefully remove the bandage from the suture, applied in a medical institution (if the bandage has dried, you should slightly soak it with hydrogen peroxide);
analyze the condition of the postoperative wound to exclude the appearance of pus, bile, swelling, etc. (if these symptoms occur, you should contact a medical facility);
if there is a small amount of blood, it should be stopped before manipulation with a bandage;
first, you should not spare the liquid, it should moisten the wound generously;
you need to wait until the product stops contacting the seam (stops hissing), then carefully wipe it off with a sterile bandage;
then, using a cotton swab, the wound along the edges is treated with brilliant green;
ointments should be applied only after the stitch begins to heal a little, approximately 3-5 days after discharge.

You can speed up the healing of postoperative sutures with the help of special ointments. They are aimed at accelerating tissue regeneration and providing an anti-inflammatory effect. Popular ointments include:

Iodine is an inexpensive and easy-to-use remedy; you can call it an analogue of brilliant green. But it is not recommended to use it frequently, every day; it is worth taking a alternate course with ointments, since the liquid can significantly dry out the skin, which will cause slow regeneration.
Dimexide is a solution widely used in postoperative practice. With the help of the drug you can not only treat the wound, but also make lotions and compresses.
Miramistin is suitable as an antiseptic. It can be used instead of hydrogen peroxide. It is believed that due to its antimicrobial properties, the drug is more effective in therapy. Apply throughout treatment to cleanse the wound.

Possible complications - what to do if the seam becomes inflamed?

complication of postoperative suture in the photo

To begin with, the patient should understand what inflammation is, how it manifests itself and is recognized, in what situation home therapy should be carried out, and when to seek medical help. The following symptoms may indicate the presence of an inflammatory process in a postoperative suture:

there is redness and swelling in the wound area;
the pain syndrome becomes stronger every day;
During palpation, a compaction is felt; as a rule, it does not have sharp boundaries;
on days 4-6, fever, chills, and symptoms of intoxication appear;
the emergence of a specific substrate from the wound, suppuration.

The causes of such complications could be the following factors:

penetration of infection into the wound;
improper care or lack of care for the postoperative suture;
incorrectly installed or inadequate drainage installed after surgery;
making a surgical error after the operation.

When the first signs of inflammation appear, it is worth carrying out hygienic treatment of the wound every day with hydrogen peroxide, iodine, and brilliant green. Repeated manipulations may be required depending on the condition of the lesion. When there is no pus, redness and swelling are observed, a one-time treatment can be used. In other cases, from 2 to 4 times a day. After treatment, it is recommended to apply a sterile bandage with ointment, which can be used during the inflammatory process.

There are typical instructions suggesting norms and rules of patient behavior described for a speedy recovery of a postoperative wound. They should be followed by every patient at home. They consist of the following points, described in the table below.

Type of load	Rules for caring for postoperative sutures
General recommendations	· eat properly, follow the diet prescribed by the doctor;
	· Use only water and baby soap to wash the wound;
	· maintain hygiene of the wounded area, rinse and clean every day;
	· do not use ointments, creams, gels, or rubs without consulting a specialist.
Shower	You should only take a shower when the wound begins to heal, becomes dry and gradually heals. The duration of the procedure should not exceed 10 minutes. The water in the bath or shower should not be too hot or cold.
Physical exercise	In the first 2-3 months you should adhere to the following recommendations:
	· do not stand in one place for more than 15 minutes, do only light homework;
	Increase the load gradually;
	· take daily walks in the fresh air;
	· try not to load the area where the seam is located;
	· It is worth including daytime sleep in therapy if there are minor loads;
	· Perform exercises only with your own weight, avoid lifting weights;
	· Only walking is considered acceptable.
Sex	Doctors recommend waiting until complete recovery before starting sexual activity. You should not experiment and take risks when intimacy brings shortness of breath, excessive sweating, and fatigue. This indicates the need to temporarily abstain from sex.
Sex	After recovery, you should gradually pick up the pace and rhythm in sexual relationships.
Trip abroad	Travel abroad can be carried out after agreement with the attending physician.
Diet	After surgery it is recommended:
	· exclude unhealthy foods (smoked, overly salted, fried, canned);
	· plant foods should predominate in the diet;
	· take additional vitamins;
	· include bran in the menu;
	· meat and fish – low-fat varieties.
Emotions	All negative emotions are contraindicated. They will adversely affect the state of the nervous system, which will lead to long-term recovery.

All recommendations are intended for general use. It must be borne in mind that any wound has its own characteristics, which should be discussed with the attending physician. Proper therapy will help you quickly get rid of unpleasant physical and mental symptoms.