Heals the outer seam. Stitches hurt after childbirth - the norm or a violation, what to do? Rules of care if the stitches hurt after childbirth. How long do stitches heal after childbirth

Today we will talk about how to care for stitches after childbirth and how to relieve pain.

When are stitches applied?

Many women during childbirth are provided with surgical prompt care followed by suturing. Surgery is not uncommon during childbirth, doctors resort to this method of assistance for several reasons:

• premature or quick delivery when the fetal head takes over heavy loads- an episiotomy is performed - an incision in the perineum to exclude trauma to the head of the newborn;
• Breech presentation during childbirth - in order to avoid the loss of the fetus, a caesarean section is performed - an incision in the abdominal wall;
• The presence of scars on the perineum after previous births - the perineum is not elastic enough;
• To exclude attempts due to health problems of the woman in labor - again, they do a caesarean;
• Prevention of perineal rupture - it is believed that the incised wound heals faster and the seam is more accurate.

Every woman in labor needs to be prepared for possible incisions that facilitate childbirth.

Postpartum suture care

The doctor examines the genital tract after childbirth and, if necessary, applies internal or external seams. The internal sutures heal almost without pain, but the external sutures are sore after childbirth for 1-2 months.

1. Internal sutures on the cervix and vaginal wall are superimposed with natural self-absorbable suture material and do not cause much discomfort. Care of the internal seams consists in observing the rules of personal hygiene and excluding sexual intercourse from one to two months.
2. The crotch is sutured using a variety of suture materials and in an amount that depends entirely on the length of the incision. Perineal sutures can be applied with both absorbable and non-absorbable materials. Severe pain in the stitches on the perineum in the first days after childbirth, since in addition to the incision itself, holes are hurt at the points of tissue puncture. It is necessary to wash the perineum twice a day with soap and rinse during the day warm water. Wash the perineum with sutures carefully and thoroughly. Dry with blotting movements from front to back, never rub. It is better to use a soft absorbent cloth. To keep the perineum dry, it is necessary to change the pads frequently, washing the stitches with a weak solution of manganese, if the stitches hurt after childbirth. For the first two weeks, a woman is not recommended to sit on both buttocks, it is better to try to sit on her side. In order to avoid constipation, since women usually do not have a stool for 1-2 days after childbirth, try not to eat food with a fixing effect. You can drink before meals a tablespoon of any vegetable oil or use laxative suppositories as recommended by your gynecologist.
3. Sutures placed on the abdomen after cesarean require permanent care during the first month. In the first week after the operation, the suture is treated daily with an antiseptic solution and the bandage is changed. Cosmetic sutures are applied with self-absorbable materials, which completely dissolve on the 60-70th day after application. It is allowed to take a shower after a week, but it is not recommended to use a hard washcloth. Try not to lift more weight than your baby's weight for the first few months. If the stitches after childbirth are very sore, in the first days, painkillers can be administered intramuscularly on the recommendation of a gynecologist.

Why do stitches hurt after childbirth?

Many women are concerned about this issue within a month after giving birth. We will give several recommendations to alleviate the condition and reduce pain on the site site:

• Painful sensations make themselves felt constantly, if you often have to sit down or lift weights - limit the weight of the objects being lifted if possible and try not to sit on both buttocks;
• The stitches on the perineum hurt after childbirth, if they suffer from constipation. In the first month after childbirth, the woman's body is rebuilt, lactation requires consumption more liquids, and for a normal bowel movement, there is not enough liquid. Breastfeeding mother should drink more warm milk, green tea, juice or herbal infusion. .
• Sometimes the stitches hurt after childbirth during sexual intercourse due to vaginal dryness and a natural load on the perineum. In this case, doctors recommend using a moisturizing gel. Sometimes reduces pain change of position to a painless one.
• The stitches hurt and pull after childbirth with inflammation of the tissues, then redness appears, purulent discharge. In this case, consult a gynecologist, but in no case self-medicate.
• Stitches after childbirth hurt because postpartum discharge form a breeding ground for microbes that cause inflammation.

On the forums of young mothers, reviews of childbirth contain many questions: why do stitches hurt after childbirth; how to care for seams; what to do if the seams come apart? Only a gynecologist can give an answer in each specific case, who will conduct an examination and prescribe treatment if necessary.

Sometimes after childbirth, it becomes necessary to suture the perineum of the woman in labor. The reason for this may be narrow birth canals, large fruit, the presence of a scar after a previous birth and poor tissue elasticity. After such a manipulation, a woman should be very careful, because with the slightest non-compliance with medical recommendations, her wound may open again. Let's consider in more detail what needs to be done if the seam has come apart after childbirth and how to prevent it.

What to do if the seam diverges after childbirth: the main causes of thread rupture

Most often, the seams after childbirth can disperse for the following reasons:

1. Infection in the wound.

2. Sitting down too early.

3. Excessive physical activity(weight lifting).

4. Execution sudden movements.

5. Early resumption sexual activity.

6. Failure to comply with hygiene rules.

7. Constipation, which led to overexertion of the muscles of the ointment and rupture of the suture.

9. Not proper care behind the seams.

10. Wearing tight or too tight underwear.

The seam broke after childbirth - what to do and how to recognize

You can recognize the sudden divergence of the postpartum suture by the following symptoms:

1. Burning sensation in the wound area.

2. Pain and tingling in the suture area.

3. The appearance of swelling of the perineum.

4. A feeling of fullness and heaviness in the wound area may indicate the development of a hematoma and accumulation of blood.

5. Bloody or purulent discharge.

6. An increase in body temperature (may occur when an infection enters the wound). In this condition, it is very important to see a doctor quickly, otherwise, because of this, a woman may lose the opportunity to breastfeed.

7. Weakness.

8. Redness in the area of ​​the seam.

The seam broke after childbirth: what to do and how to be

At the first suspicion of a rupture of the seam, you should contact your observing gynecologist as soon as possible. After the examination, the doctor will prescribe necessary drugs and procedures.

Traditional treatment divergence of seams provides:

1. The use of anti-inflammatory and healing ointments (Levomekol, Synthomycin, Vishnevsky ointment). These remedies will help get rid of swelling, pain and redness. They also disinfect the wound and contribute to its rapid healing.

2. If the sutures were still very “fresh” and dispersed literally on the second day after the birth, then most likely the doctor will prescribe re-suturing. In this case, the wound must be washed with antiseptics so that the infection cannot enter it.

It is important to know that when applying postoperative sutures, it is recommended that a woman in labor be in the hospital for five days under medical supervision, and not rush to leave home, since it is in the conditions of the hospital and its sterility that you can protect yourself more.

3. If the seams have parted after the wound has healed, then there are two options for the development of treatment:

If the wound does not pose a threat to the woman's health, then the doctor can leave everything as it is and not apply repeated stitches;

If the seam is completely open, then the edges of the wound are cut again and the threads are re-applied, otherwise an infection can easily get into the seam, and even such a condition will cause discomfort to the young mother all the time.

4. In the event that it was not the seam itself that broke, but only a few of its stitches, then this situation does not require repeated surgical intervention. Instead, the wound must be treated with disinfectant ointments and solutions.

5. Much great danger represents the divergence of the seam after caesarean section, since in this case the wound runs through the entire anterior part of the peritoneum. In addition, it is quite large and more prone to tearing (due to the fact that the suture is placed on the abdominal muscle, which contracts with almost any physical movement).

It is much easier to see such a divergence of the seam, because it is clearly visible, unlike the seam on the perineum, the rupture of which can only be accurately determined by a gynecologist. In this case, the woman will feel severe pain and burning in a standing and sitting position. In addition, she will ooze blood from the wound.

In this case, you need to see a doctor as soon as possible. Doctors usually do re-suturing.

6. With severe suppuration of the wound and high temperature in a woman, she is prescribed strong antibiotics, antipyretic and anti-inflammatory drugs. After taking them breast-feeding will, unfortunately, be impossible.

Generally, wound healing time depends on the type of sutures that are used for suturing. To date, natural threads, synthetic and self-absorbable threads are practiced. Metal staples are rarely used.

The healing period of absorbable materials takes two to three weeks. As for non-absorbable synthetic threads, they heal longer - from two to three months.

What to do so that the seam does not open after childbirth: wound care

Proper suture care after childbirth is a guarantee fast healing wounds and prevention of infection. To do this, follow these recommendations:

1. Regularly lubricate the wound antibacterial agents. In the first days after childbirth, the gynecologist himself usually processes the suture, but even after arriving home, it is important to continue these procedures on your own.

2. Wash stitches with soap.

3. Wash yourself after every urination and bowel movement to prevent infection.

4. Change the gasket every two hours.

5. Wipe dry after a shower with a clean towel.

6. On the first day after childbirth, you need to delay the act of defecation so as not to “strain” the seam. To do this, a woman should eat only liquid meals in small portions.

7. Daily treat the wound with brilliant green. You can also apply absorbable and healing ointments, but only when prescribed by a doctor.

In addition, with prolonged healing, irradiation with special lamps can be used. Is being done this procedure at the gynecologist.

As additional prevention a woman is recommended to visit a gynecologist once a week and conduct a control examination of the wound.

What to do to prevent divergence of seams after childbirth: prevention tips

To minimize the risk of seam divergence after childbirth, you should follow these tips:

1. In the first days after childbirth, a woman should not sit. All manipulations (including nutrition, feeding a child, etc.) must be performed in a lying or standing position. Moreover, even after discharge, when traveling home, you need to leave lying down, having previously unfolded the chair in the car. Only after four weeks (if everything goes well and there are no complications) can you fully sit down.

2. Sexual life should be abandoned until the stitches are removed, since it is usually this factor provokes an earlier divergence of threads. Besides, sex life can contribute to infection in a fresh wound, which will only prolong the rehabilitation process.

3. Follow the rules of personal hygiene.

4. Wash with baby soap without dyes and fragrances that can cause irritation.

5. Seamless loose underwear made from natural fabrics or special disposable panties should be worn. Wear tight models or tight underwear should not be until the wound is completely healed.

6. Treat the seam with antiseptics twice a day.

7. Maintain hygiene in the perineal area and with bloody or mucous discharge, which may be after childbirth, change pads as often as possible.

8. Special attention should be given nutrition so as not to cause constipation. Thus, it is better to temporarily stop eating starchy foods and sweets. Instead, it is better to give preference to fermented milk products (kefir, cottage cheese), as they not only normalize stools, but also improve the overall intestinal microflora.

It is important to know that it is impossible to take painkillers on your own, especially when a young mother is feeding a child. breast milk. This is explained by the fact that most medical preparations can be excreted from the body with biological fluid, including with breast milk, which the baby will then drink. This, in turn, can cause the newborn to serious problems able.

Before taking any medication, be sure to consult with your doctor.

During labor activity women in labor have tears and cracks in the vagina, on the cervix and perineum. Today it is not scary, obstetricians quickly eliminate unpleasant consequence delivery. Internal seams after childbirth are painful and heal for a long time. To speed up the process as much as possible, you need to take care of them and process them.

Based on the place to be sutured, the internal (uterus, vagina) and external sutures (perineum) are separated. Each option is performed differently and uses a special material, so the scars need careful care and proper hygiene.

Internal sutures on the cervix occur due to the large size of the fetus. Anesthesia is not used, because the pain threshold after the child passes birth canal has not yet decreased. Sew with catgut, self-absorbable threads that do not need to be removed.

Sometimes Vicryl or Kapron is used. The sewing material is hypoallergenic, does not feel, does not cause discomfort. The procedure does not require special care, because the scar is deep in the middle of the vagina.

Internal and external sutures on the vagina appear through trauma during childbirth, with small and deep tears. When applying seams, use local anesthesia novocaine injections. Postpartum internal seams on the vagina they make catgut threads that do not need to be removed. Scars are felt and remain painful for 2-3 days and do not need special care.

The stitches on the perineum are applied due to cracks, trauma during childbirth and after episiotomy. Internal and external seams on the perineum are made with a special material, based on the degree of complexity of the rupture or dissection.

Catgut is used for light cracks, and silk or nylon for deep wounds. use local anesthesia by injecting the desired area with lidocaine. Scars on the perineum hurt for a long time, cause discomfort, require sexual rest, proper hygiene(after each trip to the toilet), treatment with septic tanks.

Healing time

After suturing the injured place, the woman in labor should know how long the recovery process is. After all, everyone wants to quickly get rid of the discomfort after childbirth.

How long does it take for internal stitches to heal? It depends on the material that was sewn. If absorbable threads are used, everything will pass in 12-14 days, the scars will heal within a month after delivery.

When using a material that does not dissolve itself, the sutures are removed after 5-6 days. The inner seam is healed with silk or vicryl. An important role is played by the peculiarity of the body. In women with good tissue regeneration, recovery is much faster.

How long the scar will heal completely depends on the ingress of microorganisms on the wound. It is required to adhere to the rules of hygiene in order to prevent infection from entering fresh scars.

Many women do not wait for the internal stitches to heal after childbirth, mothers are looking for ways to recover as soon as possible after the baby is born. But the most important rule in this case is hygiene and compliance with the recommendations of the obstetrician.

Diagnostics. Before discharge from the hospital, the doctor examines the internal seams. Next, the woman is sent for an ultrasound, where they look at the sutured areas. Because of how the internal seams look after childbirth, it depends whether the woman in labor goes home or not.

Usually the stitches on the uterus are not removed, they remain for life. If catgut was applied, the internal sutures resolve on their own after childbirth.

• do not get up for the first 2-3 days after the birth process;
• sit on the floor lying down first week;
• feed the baby only from the “lying down” position so as not to create additional pressure on the uterus;
• resume sexual life after 2-2.5 months;
• change the pad no later than 3 hours to prevent infection in open wounds.

In a month, the internal and external seams will heal quickly, the feeling of discomfort will leave the woman forever. After the appearance of the child, it is required to come to an appointment with the local gynecologist at the place of residence. He will conduct an examination and make a conclusion about the condition of the postpartum scars.

Care

The internal seams do not require special attention. Due to postpartum lochia, a woman in labor does not have the opportunity to disinfect wounds and lay sterile tampons.

Following simple recommendations, it is possible to reduce the period for which tears and scars heal after childbirth. You should not be overloaded with homework, you need to get enough sleep and not overcool. If you experience discomfort in the area of ​​the postpartum scar, you should consult a gynecologist, this may be a symptom of complications.

To prevent the internal seams from being tightened for a long time, it is required:

1. adhere to personal hygiene (frequently wash, change the gasket);
2. do not use tight pants so as not to squeeze the uterus;
3. release on time bladder so that it does not interfere with the contraction of the uterus;
4. do not lift anything heavier than your child;
5. carry out defecation in a timely manner, because constipation affects the muscles of the perineum, which causes additional pain and discomfort.

You need to eat right for timely bowel movements, drink a teaspoon of vegetable oil or flax to prevent constipation. If the internal seams itch, this is good, the sensations indicate the fusion of tissues.

To alleviate discomfort, it is recommended to frequently wash with warm water without soap. It happens that the mother feels discomfort or pain at the site of the scar. This means that the recovery process did not go as expected.

Possible Complications

Can internal stitches hurt? The phenomenon is quite possible, it is caused by difficulties with healing open wounds. Then it is required medical intervention including medication and antiseptic treatment. The obstetrician must take action and prescribe adequate treatment scar healing pathology.

Why internal seams hurt after childbirth:

• due to discrepancy (total or partial);
• through the peculiarity of the period of wound healing;
• suppuration is present;
• due to bleeding

How long do internal stitches hurt after childbirth? It depends on the nature of the wound, the location and the ability of body tissues to recover quickly. If the internal seams hurt for a long time, due to the slow regeneration of cells, the woman in labor is prescribed warming up.

The procedure is carried out no earlier than 2 weeks after childbirth, when the uterus has shrunk to its original size. The scar is heated for 10 minutes for 14 days, or until the discomfort is completely gone.

What to do if the internal seams hurt after childbirth:

• contact a gynecologist;
• undergo an examination;
• take treatment.

If you need hospitalization, do not hesitate, otherwise the consequences will be terrible. Ignoring the advice of an obstetrician, a woman provokes the appearance of complications in the postpartum period.

When the seam diverges - it's scary, it opens internal bleeding which is hard to stop. It is required to react quickly and go to the gynecologist. If there is a complication, treatment is prescribed for partial divergence and re-suturing for complete.

When a scar inside the vagina has festered, a red-green discharge appears in a woman, with bad smell. You need to notify the gynecologist about the pathology, because the presence of infection in postpartum stitches dangerous to infect the body. Prescribe anti-inflammatory drugs, treatment of wounds with septic tanks and healing ointments.

If it bleeds internal scar- it's anomalous. The case was provoked by the neglect of the doctor's recommendations. For example, when a woman began to sit down or lift weights ahead of schedule. In this situation, you need to immediately seek help so as not to miss the moment. Uterine bleeding can be stopped in the first hours after its appearance.

Scars after caesarean section

In operative delivery, there are also internal and external sutures. It's a scar on the uterus abdominal wall and lower abdomen. As a rule, during such childbirth, a woman stays in the hospital longer. A nurse takes care of the wounds, changes the dressings and treats the scars with cutasept.

The first week a woman wears postoperative bandage, which supports the internal seams. On the first day, you should not take a shower, then it is not prohibited, just after each trip to the bathroom, you need to dry the wound dry. For more quick recovery tissues of the woman in labor are prescribed healing ointments or suppositories.

With poor-quality scar care, complications associated with infection occur. Then the spike starts to ooze and appears heat. The doctor prescribes antiseptic therapy for several days, then everything goes away. It happens that the seams diverge, this is a sign that the woman lifted weights. This complication is eliminated by suturing the injured area.

The body is fully restored after caesarean section not earlier than 2-3 months from the date of birth. All this time it is worth limiting yourself in sports, sexual activity and large physical activity. Then postpartum period will pass quickly and without any pathologies.

Childbirth is always a risk of ruptures and cracks, as well as an emergency caesarean section. Therefore, choosing an obstetrician-gynecologist, you need to be sure that he will perform high-quality suturing. Postpartum scar care is also important. Neglect of the doctor's recommendations provokes the appearance serious complications postpartum period.

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;
baby is born in breech presentation- the tissues of the perineum are dissected so that there are no obstacles at the birth of the head;
at anatomical features the woman's perineum (tissues are inelastic or there is a scar from 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 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, the available options, the technique adopted in this medical institution, and other circumstances. So, synthetic or natural bioresorbable can be used. suture material, non-absorbable suture or metal staples. 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 small wounds and sutures occur within 2 weeks - 1 month after childbirth, deeper injuries heal much longer. AT 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 to follow 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, the sutures on the perineum are processed by the midwife of the department 1-2 times a day. To do this, she uses "zelenka" or concentrated solution"manganese".

The stitches on the perineum, as a rule, are also applied with absorbable threads. The nodules fall off on the 3rd-4th day - in last day 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 crotch seams also important role plays compliance with the rules of personal hygiene. 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. Speaking of the toilet, many women are afraid 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 the woman was given before childbirth. 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 side damage. You need to sit on a hard surface. On the 10-14th day, you can sit on both buttocks. The presence of seams 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 lamp. 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, reduce discomfort in the area of ​​the scar.

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 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 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 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 to a woman intramuscularly, help to cope with painful sensations. But already from the first days to reduce pain mom is recommended to wear a special postpartum bandage or tie up the 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 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 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.

Childbirth may be accompanied by ruptures in the tissues of the birth canal or special incisions made by the doctor. This procedure is called an episiotomy or perineotomy, depending on the direction of the incision. Wounds are carefully sutured, and the sutures in the perineal region require special care.

Varieties of postpartum wounds

Childbirth through natural ways may result in tissues of the cervix, vagina, or perineum. Injuries are more likely to occur on altered tissues if there is an acute or chronic inflammation. The cervix or vagina acquire a loose structure, the epithelium becomes thinner. Therefore, during childbirth, cracks or deeper tears occur at the moment of friction. It is impossible to prevent injury to the vagina or cervix. The only prevention timely treatment inflammatory diseases and correct behavior in childbirth.

Perineal ruptures can occur with insufficiently elastic tissues, a large fetal head. incised wound heals better than a torn one, a neat scar is formed and there is less risk of complications or deep ruptures. Therefore, when signs of tissue spreading appear, the doctor makes an incision in the direction of the ischial tuberosity -.

Depending on the localization of the wound, the suture material is selected:

• internal sutures are placed on the cervix and vaginal tissues, absorbable catgut material is used;
• external ones are made on the perineum with non-absorbable threads.

Features of cervical and vaginal ruptures

The cervix is ​​torn during rapid labor, a large child, or in cases where the woman in labor begins to push with incomplete disclosure. Tears appear on the neck, changed by scar tissue after the treatment of erosion, previous injuries. A rupture can be suspected by the appearance a small amount blood during childbirth. But most often they are found during the examination of the birth canal after the birth of the placenta.

Typical places of breaks on the neck are at 3 and 9 o'clock of the conventional dial. Anesthesia during suturing is not needed, the tissues lose their sensitivity. The doctor may apply continuous or separate interrupted sutures. The choice of technique depends on the depth of the fracture and individual characteristics wounds.

Tears in the vagina are also found during the examination. They can have a different depth, but more often affect the integumentary tissues. Anesthesia is used for suturing. Apply local funds in the form of an injection of Novocaine or Lidocaine. Self-absorbable sutures are applied. Their threads will come out naturally along with secretions.

With deep ruptures of the vagina, as well as women who underwent manual separation placenta or examination of the uterine cavity, tissues are sutured under anesthesia.

How long after childbirth do the stitches on the cervix or in the vagina dissolve?

It depends on the individual characteristics, the depth of the gap and the absence of complications. Most often, complete healing of the cervix takes 2-4 weeks, the vagina - up to 3 weeks.

Wound after episiotomy

A neat incision on the perineum can have a different depth. The length of the incision ranges from 4 cm. Sometimes the doctor cuts only the skin and subcutaneous tissue, this is enough for the normal continuation of labor and the prevention of rupture. But in severe cases the incision touches the edge of the muscle. This affects the nature of the seams:

• a small incision is sutured with one row of sutures;
• a deep incision is sutured in 2 stages: first, they are connected with absorbable threads deep tissues, then non-absorbable - the skin.

A similar tactic for those who did not have time to warn. Assistance is different if a deep gap has formed that has affected the tissues of the rectum. In this case, the help of proctologists or abdominal surgeons is required, the operation is performed under anesthesia.

Episiotomy and perineotomy differ in the direction of the incision

The external sutures are placed in separate knots. The doctor begins to sew from the corner of the wound in the direction of the vagina, matching its edges to form a vulvar ring. The number of nodes depends on the length of the wound.

Sometimes cosmetic sutures are applied, which are performed with a continuous thread that is superimposed inside the skin in a zigzag pattern. After healing and removal of sutures, the scar becomes almost invisible. But most often this type is used during a caesarean section.

How long does it take for sutures to heal after an episiotomy?

The healing time is determined by the depth of the wound. The smaller the incision, the faster the restoration of tissue integrity. Remove suture material normal course postpartum period before discharge on the 5th day. But after tears, deep cuts, it may take up to 10 days. Then the nodes will be removed in antenatal clinic or when contacting admission department maternity hospital.

But the removal of the threads does not yet mean the full formation of the scar, this process stretches for a month or more with deep wounds.

Features of wound care

To avoid infectious complications helps with proper care of the seams.

Internal wounds do not require special treatment. In some maternity hospitals, they are lubricated during examination on the chair with a solution of potassium permanganate, but most often doctors try not to interfere with the vagina during healing. This is accompanied by pain and increases the risk of infection.

The first treatment of postpartum sutures on the perineum is carried out in the delivery room, they are lubricated with a solution of brilliant green. After returning to the ward and a short rest, the young mother should take a shower and clean herself up. Enough plain water without the use of soaps and gels. The episiotomy area will hurt, this place is washed gently, dried with a sterile diaper with blotting movements.

Wounds on the perineum require careful hygiene. The doctor tells the woman during the first round how to care for the stitches after childbirth. So that the wounds dry up, and they do not develop anaerobic infection requires constant air supply. A woman is advised to spend as much time as possible without underwear lying on her back in bed and bending her knees. If there is a need for underwear, then you need to follow the following tips:

• choose panties made from natural fabrics;
• use disposable panties made of non-woven materials;
• use sterile diapers or pads.

Sterile liners are changed after each visit to the toilet. in the early days a lot, so you can use urological pads. They have long length and absorbency. The pads are changed every 3-4 hours so that the wound has minimal contact with vaginal discharge. Lochia is a breeding ground for bacteria that can cause complications.

In the maternity hospital, they try to smear the seams with a solution of brilliant green. Some clinics use a strong solution of potassium permanganate, iodine is used very rarely for this procedure. The treatment is carried out daily by a nurse. During the daily bypass, the doctor must inspect the sutures in order to control their healing and notice signs of complications in time.

Special treatment of seams at home is not required, unless otherwise prescribed by a doctor. It is enough to observe hygiene, change pads and wash yourself after each visit to the toilet.

How much stitches hurt depends on the individual pain threshold. Expressed pain syndrome Most women go away in a few days. You can reduce it with an ice pack or special chilled gel pads. Irrigation is prescribed for sensitive patients for pain relief local anesthetics, anesthetic gels. Less often, Analgin or other non-steroidal anti-inflammatory drugs are used.

By the time of discharge, there may be a slight tingling sensation, a feeling of discomfort, but there should not be acute or unbearable pain. This is a sign of inflammation.

Lifestyle during healing

To prevent the tissues in the wound from spreading, doctors do not allow sitting on the buttocks.

How long can you not sit after childbirth with stitches?

The period depends on the size of the incision. Many doctors follow the old rule that the number of weeks corresponds to the number of stitches. Therefore, with a small incision that required 3 stitches, you can not sit down for 3 weeks. Those who received 5 stitches need to lie down or stand for 5 weeks. The ban on sitting makes a special way of life in the maternity hospital:

• the child will have to be fed in the supine position;
• get up from a bed or an examination chair with an emphasis on side surface hips;
• you need to eat while standing; in the canteens of maternity hospitals, special high tables are equipped for this at chest level;
• At home, you will also have to eat standing up or reclining.

In advance, you need to think about the moment of discharge from the hospital and transportation home. For a young mother, you need an empty back seat of the car so that she reclining freely on her side.

Hygiene procedures during the healing of sutures are carried out after each visit to the toilet. If there is a bidet in the room, it makes cleaning easier. In other cases, you need to use the shower. The water jet is directed from front to back. You can not try to pour it into the vagina, wash given area fingers. To wash the perineum, a separate sponge is used, not intended for the rest of the body.

In the first month of the postpartum period, you can not lie in hot tub, it is harmful to the shrinking uterus and the scar on the perineum. The main way to wash is the shower.

Pat the perineum with a separate towel, which is changed each time after use.

After being discharged home, you can not immediately switch to lace, synthetic or slimming underwear. It does not allow the body to breathe, and slimming models disrupt microcirculation and impair healing.

After giving birth, women may have problems with bowel movements. Pain in the perineum occurs after normal delivery, and for those who had an episiotomy, discomfort is stronger. Therefore, many are afraid to empty their intestines.

The first urge to defecate appear for 2-3 days. They cannot be restrained. Otherwise, the feces lose water, thicken, and constipation occurs. Then going to the toilet will be much more painful.

If the desire to empty the intestines does not appear on its own or there is fear due to the episiotomy, laxatives can be used:

• Castor oil;
• lactulose solution (Duphalac);
• microclysters Microlax.

An alternative to laxatives is a cleansing enema. It can be avoided with proper nutrition. Women are advised to avoid foods that help to bind feces and develop constipation:

• baking, pastries made from white flour;
• potato;
• strong tea.

AT daily diet there should be foods that contain fiber and are able to speed up the passage stool in the intestines:

• vegetable oil;
• prunes;
• dried apricots;
• beet;
• bran bread.

A young mother should eat a lot of vegetables and fruits, consume dairy products, lean meat, so that the stool remains normal. A nursing mother has an increased need for fluid. Lack of water will lead to the development of constipation and deterioration of healing, so you need to drink 2-2.5 liters per day.

Thread removal

The suture material on the perineum is removed on the 5th day on the day of discharge, if there are no complications. The removal period will be postponed for deep tears or tissue incisions.

If the cervix or vagina is torn, the threads are not removed, they will resolve themselves. Threads come out of the seam along with lochia. They can be seen on the pad a few weeks after birth.

Whether it hurts to remove stitches after an episiotomy, each woman evaluates subjectively. Some feel tingling, burning.

The doctor removes the threads from the perineum during the examination before discharge or trusts the midwife. To do this, use tweezers and sterile scissors. The procedure is carried out on a gynecological chair. Each knot is gently lifted above the skin and one thread is cut, the remnants are pulled out. At this point, an unpleasant painful sensation may occur.

Cosmetic threads are removed differently. Retaining beads are cut off from the ends and gently pulled it out of the skin. This can also be accompanied by discomfort.

After removal, the wounds are treated with brilliant green.

Possible Complications

The first complications may arise already in the hospital. The most common conditions are:

• infectious;
• hematoma;
• discrepancy.

The appearance of redness in the area of ​​the wound, swelling, increased pain is a sign of infection. AT initial stage physiotherapy is prescribed in the maternity hospital. The use of quartz treatment on a wound, ultraviolet or infrared radiation is effective.

Sometimes appears at the seams white coating. This is a sign of a fungal infection. In order not to cause a divergence of the edges of the wound, treatment with antifungal ointments. Effective preparations based on Clotrimazole, Pimafucin. They operate locally.

If the stitches fester after childbirth, then antibiotics should be prescribed. Tactics depends on the severity of inflammation. In severe cases, the wound is opened under local anesthesia, remove purulent contents, wash with antiseptic solutions:

• furatsilin;
• hydrogen peroxide;
• potassium permanganate.

Sometimes wipes soaked in solutions of proteolytic enzymes are used. They help clean the surface of the wound and speed up healing. After treatment, the perineum heals secondary tension without tightening the edges with threads.

If the vessel is damaged in the area of ​​​​the episiotomous wound, blood can accumulate, a hematoma is formed. Blood can accumulate in the area of ​​the labia, impregnate the fiber. The woman feels an increase in soreness in the perineum, a feeling of fullness in the wound area. Large hematomas can put pressure on the rectum, bladder and make it difficult to go to the toilet. Body temperature remains normal.

Treatment for a hematoma depends on its size. At small sizes, an ice pack is applied to the hearth. Large hematomas require surgical care.

The divergence of the edges of the scar may occur in the hospital or after registration home. This condition threatens only wounds on the perineum. Worries about whether the internal seams can disperse are in vain. signs dangerous state the following:

• increased pain;
• puffiness;
• the seams seem to “pull”;
• redness in the area of ​​the wound.

What to do if the seams come apart?

You need to tell your doctor about this. If the symptoms appeared in the hospital, the tactics will depend on the duration and severity of the pathology. In 1-2 days, the wound is treated with antiseptics and repeated stitches are applied. If there are signs of suppuration, antibiotics and wound cleansing are needed. What to process postpartum sutures in this case, it is decided individually. Ointments with antibiotics, antiseptics can be used.

Women who have a discrepancy at home are not re-sutured. Recommend treatment with antiseptics, hygiene, prescribe antibacterial drugs in the form of ointments.

2 weeks after giving birth, some young mothers begin to complain that the stitches itch. This symptom refers to the normal manifestations of the wound healing process. If it does not occur additional features inflammation, then special treatment not required.