Everything about stitches after childbirth: external, internal, cosmetic. How long does it take for stitches to heal after childbirth: features of scar care. When to remove sutures after childbirth and how long do they take to heal External sutures after childbirth when to heal

The process of giving birth to a baby does not always go perfectly smoothly. Sometimes the birth canal is injured when a child passes through it, and if the damage is significant, the tissue has to be sutured. Sutures after childbirth are also inevitable if delivery was carried out by caesarean section. It is useful to know what types of sutures exist, how quickly they heal, and what should be done to prevent complications.

Situations when suturing is required after childbirth

After natural childbirth, sutures are used when the cervix, vagina or perineum is torn, or when an incision had to be made during childbirth to prevent their rupture (an even incision heals much faster than a laceration).

The cause of cervical rupture in most cases is insufficient opening of the cervix during strong pushing. This happens with rapid or premature birth. The cervix may also not be able to withstand strong stretching during childbirth if:

• large size of the fruit;
• breech presentation of the child;
• the presence of a rough scar on the cervix after a rupture during a previous birth;
• abnormal structure of the cervical canal.

Spontaneous perineal rupture is a rare occurrence. If the obstetrician sees that the baby's head, shoulders or pelvis clearly will not pass through the perineum, and there is a threat of its rupture, he performs an episiotomy - he cuts the skin and muscles of the perineum in the direction of the ischial tuberosities. Episiotomy is also performed in case of extreme weakness of pushing, in case of fetal hypoxia or anomalies in its development, when labor needs to be accelerated and the most gentle conditions created for the child.

Vaginal ruptures occur in women with a clinically narrow pelvis, an underdeveloped vagina, or form as a continuation of perineal ruptures. Damage to vaginal tissue that requires sutures can be caused by the use of obstetric forceps. In this case, sutures are applied both to restore the integrity of the birth canal and to stop bleeding, which can be very massive when the vagina ruptures.

During a caesarean section, which is most often performed using a transverse incision, stitches are placed in the skin, subcutaneous fat and uterus. Due to the relatively short length of the suture and its location in the suprapubic fold, the scar from it becomes almost invisible over time.

Types of sutures and their healing time

For suturing after childbirth use:

• Absorbable natural threads (catgut, chrome catgut).
• Absorbable synthetic threads (vicryl, occelon, dexon).
• Non-absorbable threads (nylon, silk, nikant), which are removed after the edges of the wound have fused.
• Surgical staples. These are nickel plates about 2 cm wide, which are used to tighten the wound like paper clips, and after it has healed, they are removed using a special tool. Used as a variant of the upper suture during caesarean section.

Pain at the site of internal sutures usually goes away after 2 days, external sutures hurt longer. The procedure for removing sutures or staples is minimally painful and does not require anesthesia. This is no more uncomfortable than eyebrow hair removal with tweezers, which is familiar to every woman.

The healing time of sutures after childbirth depends on the type of suture, its size and characteristics of the body. When performing internal sutures on the cervix or vagina, the wound heals in 1 to 2 weeks, and the suture material is completely absorbed within a month. Non-absorbable sutures or surgical staples used to make external sutures are removed on the fifth or sixth day, wound healing takes from 2 to 4 weeks.

If the stitches have come apart or are festering

It happens that the seams become inflamed or come apart. Symptoms of external suture dehiscence may include sharp pain at the suture site, redness, or swelling. If the suture has partially come apart and the wound has almost healed, it does not need to be reapplied. If this happens before the edges of the wound heal, it is cut and sutured again. It is most often possible to discover that the internal suture has come apart during the next examination by a gynecologist - the only sign noticeable to the woman herself may be bloody discharge.

If the rules of asepsis are not followed, the suture may become suppurated. The onset of the inflammatory process may be indicated by increasing pain, heaviness in the lower abdomen, elevated temperature, and atypical discharge. In order to prevent suppuration of the suture and damage to its integrity, if the above symptoms are detected, you must immediately consult a doctor. He will prescribe additional measures to treat the suture: tampons with Vishnevsky ointment, Levimikol and other anti-inflammatory and antimicrobial agents.

How to care for seams

Internal seams, if there are no problems with their healing, are not processed and do not require special care. External sutures, regardless of what material they are made with, must be treated until the wound heals completely. In the maternity hospital, midwives do the daily treatment of sutures; after discharge, this must be done independently.

Twice a day, using a cotton swab, apply a solution of brilliant green or potassium permanganate to the seam (you can first moisten the seam with hydrogen peroxide). You should not treat seams with iodine or medical alcohol; they can cause skin burns. It is also not necessary to remove whitish plaque and crusts from the seam, so as not to damage the emerging young epithelium.

For successful healing of the sutures, the first couple of weeks should follow a diet that facilitates the process of bowel movements: if you push too hard, the suture may come apart. If you have problems with bowel movements, it is better not to risk it, but to put a glycerin suppository or do an enema.

Features of caring for seams on the perineum

If there is a seam on the perineum, the sanitary pad should be changed every 2-3 hours. After visiting the toilet, it is advisable to wash yourself with a running stream of water in the direction from the pubis, and then blot the seam with a napkin or towel. The best option for underwear is cotton panties that allow air to pass through and do not damage the seams, or “breathable” disposable panties.

After applying a suture to the perineum, you cannot sit for at least a week and a half - even when leaving the maternity hospital you will have to recline. You can feed and change the baby, eat food, and do some housework while standing or lying down. After 10 days, you can begin to carefully sit down on a hard surface or a special inflatable ring, and only after a month can you sit down normally.

If you conscientiously follow the doctor's recommendations, the recovery period after childbirth with tears or incisions is 2 months. During this time, the wound heals, the muscles of the intimate area regain normal elasticity, the mucous membrane is restored, and you can consider yourself ready to resume all marital responsibilities.

During childbirth, it may be necessary to cut the perineum or, in the worst case, rupture of the vagina or cervix. Then obstetricians-gynecologists sew up the damaged tissue. Stitches can cause pain and inconvenience to a young mother, and with improper care and neglect of physical limitations, they can completely come apart, which will entail undesirable consequences.

Types of postpartum sutures

After childbirth, sutures are applied when soft tissues are damaged to speed up their healing and prevent undesirable consequences (suppuration, inflammation, etc.). During natural childbirth, the walls of the uterus, cervix, and vagina may rupture. Often, doctors specially cut the perineum to facilitate the process of removing the fetus and prevent ruptures, because the cut heals faster and less often leads to complications. If the mother has undergone a caesarean section, the uterine wall, intramuscular tissue and skin on the abdomen are sutured. Let's take a closer look at the types of postpartum sutures during natural childbirth:

• Sutures on the cervix. They are applied when tissue ruptures due to insufficient dilatation of the cervix. The cervix is ​​sutured “live” immediately after childbirth. Anesthesia is not required due to partial loss of sensitivity of the organ during childbirth. Most often, self-absorbable material is used; threads do not require subsequent removal and specific care in the postpartum period.
• Stitches in the vagina. The causes of vaginal rupture are insufficient elasticity or physiological characteristics. When stitching, local anesthesia or general short-term anesthesia is used, since the sensations during the procedure are painful.
• Stitches on the crotch. The most common type of tear is in the perineum. There are three degrees of ruptures, 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 and rectal muscles. To prevent 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. Sutures are applied 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 stitched 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 years;
• narrow pelvis of a woman in labor;
• rapid labor;
• the presence of scars on the perineum from previous births;
• structural features of the perineum and others.

Why do the seams in the perineum come apart after childbirth?

Sutures made from non-absorbable materials are usually removed 5–7 days after birth in a maternity hospital or antenatal clinic. The procedure is usually not painful, but rather a little uncomfortable. Unlike internal sutures on the uterus or vagina, on the perineum they are more likely to become inflamed due to constant contact with lochia (postpartum discharge) and the physical activity of the young mother. We list the most common causes of suture dehiscence after childbirth:

• non-compliance with bed rest in the first days after childbirth;
• premature sitting down;
• heavy lifting and sudden movements;
• constipation, causing pressure on damaged tissues;
• wound infection;
• insufficient genital hygiene;
• wearing tight underwear made of non-natural fabrics;
• sexual activity before the sutures heal.

Re-overlay

Internal seams diverge extremely rarely, unlike stitches on the perineum, since the muscles on the cervix and vagina are less mobile and are not subject to mechanical damage. However, this can happen with premature intercourse, for example. If, during a self-examination, you find that the suture looks suspicious and causes severe pain while walking, you must urgently contact a gynecologist at the antenatal clinic or maternity hospital from where you were discharged. It is possible to reliably establish the divergence of the seam only during examination on the doctor’s chair. It is advisable to contact an obstetrician-gynecologist who delivered the child and is well acquainted with the medical history in order to carry out the necessary surgical procedures and re-suturing, if necessary, as quickly as possible.

If the wound has healed and the suture looks healthy, but there are small areas of inflammation, the doctor may prescribe antibacterial therapy - treatment with antiseptic solutions, anti-inflammatory ointments, or the use of rectal suppositories for internal injuries. It’s another matter if the wound is still fresh, but the stitches are already coming apart. In this case, a repeat operation with suturing is usually prescribed. If this happened in a hospital setting, the doctor will notice the failure of the suture during examination and will re-suture it as soon as possible. In this case, local anesthesia is used and there is practically no pain. The suturing procedure is similar to the initial suturing after childbirth. The operation only takes about half an hour. After the procedure, standard measures to prevent suture dehiscence and means for disinfection and speedy wound healing are prescribed.
In a situation where complete or partial suture dehiscence has already occurred at home, the tissue may become inflamed due to infection in the open wound. Repeated dissection is necessary with possible partial removal of inflamed areas and suppuration. The woman is under general or local anesthesia; as a rule, there is no pain. The wound is first thoroughly washed with antiseptics, and then again dissected and sutured in a hospital setting, using standard materials and postpartum suturing techniques. The patient is recommended to remain in the hospital under medical supervision for 5-6 days before the sutures are removed if non-absorbable material is used. On the recommendation of a doctor, in addition to standard suture care products, antibiotics may be prescribed to prevent the development of the inflammatory process. Pain after all manipulations can be quite intense with complete dissection of the suture or insignificant with partial divergence and no complications after surgery.
The appearance of the suture subsequently depends on the quality of the surgeons’ work 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 ranges 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

Internal seams come apart quite rarely. This can happen if the body rejects the suture material due to individual intolerance to its components. Dehiscence of external stitches on the perineum is more common and usually occurs within a few days after the threads are removed. A woman may feel discomfort in this area and notice suspicious discharge. If you suspect something is wrong, examine your genitals using a mirror. If the external suture does not bleed or look inflamed, most likely the cause of concern is gynecological problems or failure of internal postpartum sutures. We list the signs of divergence of the external seam that should alert a young mother:

• changes in the color and consistency of vaginal discharge - the appearance of blood or purulent inclusions;
• redness and swelling of the genitals;
• increased body temperature;
• burning at the wound site;
• acute pain in the perineum, aggravated by movement.

Therapy after re-suturing

After suturing, you cannot do without the use of antiseptic drugs, which are used to treat the wound until it heals completely 1-2 times a day. These include:

• brilliant green;
• potassium permanganate solution;
• furatsilin solution;
• Chlorhexidine;
• hydrogen peroxide;
• Miramistin;
• medical alcohol.

If complications develop, the sutures heal slowly, or after they are re-applied, the doctor may prescribe a course of treatment using anti-inflammatory medications. A gauze pad is impregnated with the medicinal composition and fixed with underwear or adhesive tape, in contact with the perineum. For internal sutures, a tampon lubricated with medication is inserted into the vagina. Change the pad or tampon 1-2 times a day in accordance with the doctor's instructions. Commonly prescribed medications include:

• Levomekol ointment. Designed for treating purulent wounds. The duration of treatment is determined individually and lasts until the discharge of pus stops. During lactation the drug is contraindicated. The ointment is considered highly effective; the result, as a rule, is noticeable within a few days after the start of use. The price of the drug is about 150 rubles.
• Vishnevsky ointment (Balsamic liniment). The specific smell of this ointment is familiar to many from childhood - in the Soviet past it was used as an external anti-inflammatory agent everywhere. The drug is considered quite effective today, and does not lose its position, despite the active development of pharmacology. It contains components of natural origin that provide a characteristic odor - 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 reasonable - about 30–50 rubles.
• Solcoseryl gel and ointment. One of the most modern means for treating postpartum and other types of sutures. The active substance is of natural origin, obtained by chemical processing of calf blood. It is used to treat wounds without purulent discharge, suitable for treating sutures with signs of inflammation, swelling, and redness. No side effects have been 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: products for treatment and healing

Solcoseryl gel is suitable for eliminating redness and swelling of sutures A solution of brilliant green is popularly called brilliant green In maternity hospitals, sutures are treated with solutions of potassium permanganate, furatsilin, Chlorhexidine, hydrogen peroxide Levomekol ointment is used to treat purulent wounds In modern pharmacies it may be difficult to find the original Vishnevsky ointment, but there are available ones analogues

Reviews from women

sewed. though the seam is not very big. I sold out because I got an infection and they didn’t pay attention to my complaints for a long time. I went to another maternity hospital (because there was no longer any trust in it. And I did the right thing) and it turned out that everything was very neglected. A “pocket” has formed with a large amount of pus (already!). First we cured this problem. treated for 1.5 months. then the seams were re-adjusted. but alas. It's really my own fault. I had to take care of myself and not lift anything heavier than a mug of tea. I decided to take a walk with my baby in a stroller. Well, I lowered them down from the fourth, without an elevator, but when I lifted them up, I tensed up. I didn’t go for a third stitch. and now it’s just plastic surgery, but I got over the disease and now I don’t have any complexes in my mind.

it's unpleasant for me

https://eva.ru/static/forums/153/2006_3/595985.html

No need to sew anything!!! And no one will stitch you up anymore, when I saw I had even more, 3 cm stitches came apart, I went to the doctor, she prescribed treatment and I did everything and everything healed on its own

Alexa

It happened to me! With my first child, the seam came apart, I went to the gynecologist, she again cut off the walls (so that they would grow together well) and stitched them up again... After the second, the seam also came apart, 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/

Advice on alterations does not help, this is decided by the doctor. And it’s not always possible to sew it up again right away; the edges should be treated. I experienced a similar situation, the doctor advised me to syringe chlorhexidine, dry it, then apply Solcoseryl GEL (4 times a day) for 5 days. After epithelialization, apply Solcoseryl ointment. And the defects can then be sharpened using a laser or cosmetic method! Be healthy!

Alexandra

I was stitched up again 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 stitch... after 10 days I was allowed to sit with stitches.

VER4EVI4

https://www.babyblog.ru/community/post/vosstanovlenie/1697328

Well, I actually had one seam come apart, I applied it with levomikol, it didn’t heal perfectly, but the gynecologist said that she didn’t see the point in plastic surgery, because... still spasms.

Natalia Milova

https://www.babyblog.ru/community/post/vosstanovlenie/1697328

But I remembered the stitches for a whole month! Until the threads fell off! Because of them, everything hurt terribly (they pulled it too tight or something). I washed myself with potassium permanganate, then with chamomile, and smeared with D-panthenol and some other healing agents. But when the threads fell off, the pain disappeared!

https://forum.materinstvo.ru/lofiversion/index.php/t26195–250.html

Prevention measures

After giving birth, a woman must follow special hygiene rules and a number of recommendations so as not to provoke rupture of the seams in the perineum. It is important to limit physical activity, regularly treat wounds with antiseptics, and avoid squats. To minimize the risk of complications, follow these recommendations:

• on the first day after birth 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 birth on a hard surface in the absence of pain;
• The baby should be fed in a lying position;
• underwear should not be tight, made from natural, breathable materials;
• begin sexual activity no earlier than 6 weeks after birth;
• It is necessary to wash yourself daily using baby soap;
• wipe the perineum with blotting movements with a clean cotton towel;
• treat the wound regularly with antiseptics and ointments as prescribed by the doctor;
• use postpartum pads until the lochia stops, change them every 2-3 hours;
• food should be dietary, preventing the development of constipation;
• if necessary, soften stool with glycerin suppositories;
• Do not lift loads that exceed 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 down or stand. After about 1–2 weeks, you are allowed to take a reclining position. Then you can try to sit on a hard chair. Only after the stitches have completely healed is it permissible to sit on soft surfaces - on a bed, sofa, pillow.

Possible negative consequences and complications

If you ignore the signs of suture dehiscence, the woman feels pain and discomfort and risks infecting the wound. In the future, such a seam will look unsightly, the skin may be deformed, and the situation can only be corrected through plastic surgery. In the postpartum period, you need to closely monitor your well-being and the appearance of the suture. We list the possible negative consequences of seam divergence.

During childbirth, situations often arise when it is necessary to apply stitches. Their presence requires increased caution from the young mother and, of course, certain skills in caring for this temporary “risk zone.”

When are stitches needed?

If the birth took place through the natural birth canal, then the sutures are the result of the restoration of the soft tissues of the cervix, vagina, and perineum. Let us recall the reasons that could lead to the need for sutures.

Cervical ruptures most often arise in a situation when the cervix has not yet fully opened, and the woman begins to push. The head puts pressure on the cervix, and the latter ruptures.

Perineal incision may appear for the following reasons:

• quick birth - 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 during rapid birth;
• the baby is born in a breech position - the tissues of the perineum are cut so that there are no obstacles during the birth of the head;
• with anatomical features of the woman’s perineum (the tissues are inelastic or there is a scar from a previous birth), due to which the baby’s head cannot be born normally;
• the expectant mother should not push due to severe myopia or for any other reasons;
• there are signs of a threat of rupture of the perineum - in this case it is better to make an incision, since the edges of a wound made with scissors heal better than the edges of a wound formed as a result of a rupture.

If the baby was born via cesarean section, then the young mother has a postoperative suture on the anterior abdominal wall.

For overlay stitches on the perineum and the anterior abdominal wall use different materials. The choice of a doctor depends on the indications, available capabilities, techniques adopted in a given medical institution, and other circumstances. Thus, synthetic or natural self-absorbable suture material, non-absorbable suture material or metal staples can be used. The last two types of suture materials are removed on the 4-6th day after birth.

Now that we have remembered why seams may appear, let's talk about how to care for them. If there is a stitch, the young mother must be fully prepared and know how to behave so that the rehabilitation period goes as smoothly as possible and does not leave any unpleasant consequences.

Stitches on the crotch

Healing of small wounds and sutures occurs within 2 weeks - 1 month after birth, deeper injuries take much longer to heal. During the postpartum period, it is necessary to take all precautions so that an infection does not develop at the site of the sutures, which can then enter the birth canal. Proper care of the damaged perineum will reduce pain and speed up wound healing.

To care for sutures on the cervix and vaginal walls, all you need to do is follow the rules of hygiene; no additional care is required. These sutures are always placed with absorbable material, so they are not removed.

In the maternity hospital, the sutures in the perineum are treated 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.

Sutures on the perineum, as a rule, are also applied with self-absorbing threads. The nodules disappear on the 3-4th day - on the last day of stay in the maternity hospital or in the first days at home. If the suture was made with non-absorbable material, the sutures are also removed on the 3-4th day.

Compliance with the rules of personal hygiene also plays an important role in caring for sutures on the perineum. Every two hours it is necessary to change the pad or diaper, regardless of its filling. You should only use 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 at such a frequency that a full bladder does not interfere with the contraction of the uterus).

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. You need to wash the seam on the crotch quite thoroughly - you can simply direct a stream of water at it. After washing, you need to dry the perineum and the area of ​​the seams by blotting the towel from front to back.

If there are stitches on the perineum, the woman is not allowed to sit 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 birth. Speaking of the toilet, many women are afraid of severe pain and try to skip bowel movements, as a result, the load on the perineal muscles 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 a cleansing enema before giving birth, and during childbirth the woman in labor does not eat. Stool appears on the 2-3rd day. To avoid constipation after childbirth, do not eat foods that have a constipating 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 sutures.

In the vast majority of cases, it is recommended to sit on the 5-7th day after birth - on the buttock opposite 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 seams on the perineum must be taken into account when traveling home from the maternity hospital: it will be convenient for the young mother to lie or half-sit in the back seat of the car. It’s good if the baby sits comfortably in his personal car seat and does not occupy his mother’s hands.

It happens that the scars remaining after the stitches have healed still cause discomfort and pain. They can be treated with heating, 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 a physical therapy room.

If a woman feels discomfort at the site of a formed scar, or the scar is rough, then to eliminate these phenomena the doctor may recommend Contractubex ointment - it should be applied 2 times a day for several weeks. With the help of this ointment, it will be possible to reduce the volume of scar tissue formed and reduce discomfort in the scar area.

Sutures after caesarean section

After a caesarean section, the sutures are monitored especially carefully. For 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 bandage are removed. If the wound was sutured with absorbable suture material (such material is used when applying a so-called cosmetic suture), then the wound is treated in the same way, but the sutures are removed (such threads are completely absorbed on the 65-80th day after surgery).

The skin scar forms approximately on the 7th day after surgery; therefore, already a week after a caesarean section you can shower completely calmly. Just don’t rub the seam with a washcloth - this can only be done in another week.

A cesarean section is a fairly serious surgical procedure 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 of ​​surgical intervention.

In the first 2-3 days, painkillers, which are administered to the woman intramuscularly, help to cope with painful sensations. But 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 come apart 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 can you say this to a woman who has to take care of a baby? Therefore, obstetricians do not recommend that parents after a cesarean section lift more than 3-4 kg during the first time (2-3 months), that is, more than the weight of the child.

Possible complications

If pain, redness, or discharge from the wound appears in the area of ​​the suture on the perineum or anterior abdominal wall: bloody, purulent or any other, then this indicates the occurrence of inflammatory complications - suppuration of the sutures or dehiscence. In this case, you need to consult a doctor.

Depending on the severity of the condition, the doctor will prescribe local treatment for the woman. In the presence of purulent-inflammatory complications, this can be Vishnevsky 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 treatment of complications should only take place under the guidance of a doctor. Perhaps a midwife will come to the patient’s home to treat the sutures, or maybe the young mother herself will have to go to the antenatal clinic, where the procedure will be performed.

Exercises for healing stitches

To speed up the healing process, whenever possible, you should try to tense your pelvic floor muscles to increase blood flow. An example of such an exercise: contract the muscles around the vagina upward and inward 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.

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A frequent complication is rupture of soft tissues during pushing and the birth of the baby. The situation in each case is individual, depending on the elasticity of the uterus and vagina, the size of the fetus and its correct attachment. If stitches cannot be avoided, daily care is necessary to promote rapid healing.

Self-absorbing sutures: advantages

Postpartum sutures can be divided into internal and external. Internal ones are applied for rupture of the cervix and vaginal walls. The cause is rapid labor, large fetuses and incomplete dilatation of the uterus.

Self-absorbable sutures are mainly used for internal organ injuries.

Access to the sutures is difficult and repeated intervention is not advisable. The resorption time directly depends on the composition of the threads. Materials are considered absorbable when their strength is lost within 30-60 days. There is an influence of water and proteins on the composition of the cross-linking fabric.

For stitching use:

1. Catgut threads disappear from 30 to 120 days, depending on the thickness of the material.
2. Lavsan – from 20 to 50 days.
3. Vicryl – 50-80 days.

Self-absorbing sutures do not require additional processing. In a month they will resolve on their own. You just need to adhere to personal hygiene, avoid sexual relations for 2 months, not carry heavy objects and promptly prevent problems with bowel movements. Doctors recommend taking a tablespoon of vegetable oil before meals to ease the process of passing stool.

How long do sutures take to heal after childbirth: a pressing issue for women in labor

External sutures after childbirth are applied when the posterior commissure is torn or when the perineum is dissected. An episiotomy is a surgical incision made to prevent vaginal rupture and free passage of the fetus during complicated labor. Suturing an even incision is less painful and better quality. Natural tears take a long time to heal and look less aesthetically pleasing.

Indications for surgical incision:

1. The threat of rupture of the perineum, which is diagnosed visually when the tissue is strongly stretched to the point of transparency. It can occur in pregnant women suffering from diabetes, skin diseases, and dry epidermis.
2. To facilitate pushing for pregnant women with pathologies of the cardiovascular system.
3. Abnormal bleeding, to speed up the birth process.
4. Premature birth.
5. Large fruit.
6. First multiple pregnancy.
7. Threat of fetal injury due to incorrect breech presentation.

An episio cut is much better than a burst wound. Smooth edges are easier to stitch, matching them as physiologically as possible. The suture heals faster without suppuration and swelling. Nylon, vicryl, and silk threads are usually applied to the external seams. They do not dissolve on their own, but provide a strong connection between the edges of the wound and the suture does not separate.

Wounds heal within 10-14 days, if there were no complications.

All this time, the woman will experience pain when walking, sitting down, or defecating. Many women are concerned about the question: how long will it take for the stitches to be removed? Usually the procedure is carried out 5-7 days after surgery, with normal healing.

How to heal stitches faster after childbirth: standard rules

In most cases, internal seams do not bother a woman. Particular attention is paid to external wounds. To heal stitches faster, you need to follow some rules. For the first 3 days, you need to wash with warm water every 2 hours. Carry out care with a sterile, lint-free towel, only blotting. Treat the perineum with brilliant green or potassium permanganate; these procedures are carried out by a nurse in the maternity hospital. Change postpartum pads frequently. Wear comfortable underwear made from natural materials.

To prevent the seam from coming apart, it is prohibited:

• Sit down for the first 10 days;
• Lift weights other than your child for 60 days;
• Be sexually active for a month;
• Comb out the seams.

After a few days, the woman in labor can sit, first on one buttock, then lean completely on a chair. It is necessary to ensure gentle bowel movements. To do this, strictly monitor your diet, avoiding constipation. It is also not recommended to shave until the scarring is complete. This procedure can cause severe irritation on the labia, which in turn leads to inflammation of the suture tissue, severe itching and suppuration.

The method of performing a cesarean section affects wound healing. This procedure is considered a strip operation, and pain may persist for several months.

In emergency surgery, the incision is made vertically, from the navel to the pubis. In this case, the abdominal walls are sutured, which makes the recovery period quite long. A horizontal suture with cosmetic suturing of the wound is more gentle. This incision looks much better and is almost invisible after scarring. After the operation, painkillers are prescribed. You can't keep track. The next day the woman should get up. Movement helps improve blood circulation, promotes contraction of the uterus and better healing of birth sutures.

How to treat sutures after childbirth: antiseptics and painkillers

It is necessary to care for sutures in the postoperative period even after discharge from the hospital. Treatment of seams at home is carried out with hydrogen peroxide and various creams: Bepanten, Solcoseryl, Levomekol. The seam on the abdomen can be treated with brilliant green, applying the drug around the wound for 3 weeks.

A special bandage, which can be purchased at orthopedic stores, will help speed up recovery.

Many women note that the stitches hurt for a long time, especially after a cesarean section and perineal rupture. The emotional state of women in labor during this period is extremely unstable, which can affect lactation. Rectal and vaginal suppositories will help to numb aching wounds: Diclofenac, Ketanol, Voltoren. You need to find out which drug is best to use from your supervising doctor.

If the wound is not properly cared for, some complications may occur:

1. Supuration of the suture. If severe pain appears when hydrogen peroxide is applied, the wounds are pinched, pulled, and yellowish discharge comes out of them, this indicates that the suture has festered. Symptoms may be accompanied by an increase in body temperature. The scar festers due to improper hygiene or due to a birth infection. The specialist will prescribe additional treatment using antibacterial drugs.
2. Seams coming apart. The situation may arise in the first days after surgery or after removal of sutures. Tissues can separate for several reasons: early sitting, too sudden movements, poor connection of the wound, infection. If the stitches come apart at home, the main thing is to contact a surgeon in time. If necessary, the doctor will re-incise and stitch the wound.
3. Suture inflammation. Painful sensations in the first days after childbirth operations are normal. When the threads are removed, but it hurts to stand, sit and pulls in the stitches, the wounds may have become inflamed. This requires the help of a specialist.

If, after returning home, the wound is bleeding, the scar is swollen, the area around it looks red, purulent discharge or lumps appear, you need to be examined by a gynecologist. Postpartum complications require immediate treatment. Inattention to the body can lead to purulent inflammation or blood poisoning.

Perineum after childbirth: forecasts for the future

For perineal ruptures, as well as episiotomies, sutures are placed immediately after childbirth. To prevent an inflammatory process from occurring, it is necessary to match the wounds as accurately as possible. If the tissues are poorly sutured, their rupture, suppuration and a long recovery period are possible. The healing process depends on the suture materials used. In rare cases, patients complain of itching in the perineum. The cause may be an allergic reaction to thread materials.

For each woman, the recovery process is individual. For some, the scars stop hurting after 5-6 weeks, for others it takes months. Many women in labor cannot understand why the scars itch. If there is no severe pain, the condition is normal. The scar itches as it heals. To relieve itching, you need to wash yourself with cool water more often. Experts recommend doing special contraction Kegel exercises, which help restore the vaginal muscles.

Some women are interested in what product will help smooth out external scars. Doctors often prescribe Contractubex ointment, which they begin to apply after the stitch has healed. Feedback from women in labor showed that the gel can improve the cosmetic effect of scars, making them lighter and less noticeable. With a caesarean section, cosmetic incisions will not be visible externally after 8-12 months.

How to treat stitches after childbirth (video)

Maintaining hygiene, following medical recommendations and an optimistic attitude contribute to positive dynamics for tissue fusion. Soon the wounds will heal, the swelling on the leg will go down, and the woman will be able to fully enjoy maternal happiness.

Childbirth is a natural process, but it is painful and traumatic for a woman. During passage through the birth canal, the child stretches the maternal tissues, which leads to small wounds and serious ruptures. If there is a threat of rupture, as well as premature birth, the fetus is too large and other problems, the doctor performs an incision (episiotomy). Incisions and tears are sutured for rapid healing. How to behave, how long it will take to recover, what complications there may be with sutures on the perineum - look in this material.

Sutures on tears after childbirth

Rapid labor, insufficient tissue elasticity, and incorrect behavior of the woman in labor (starting to push too early) lead to the appearance of ruptures. A correctly and timely episiotomy is much better than a rupture: the doctor uses a sharp scalpel to make a neat incision that is easy to stitch up. Lacerations that occur during childbirth require more stitches, can leave an unsightly scar, and take up to 5 months to heal (internal stitches).

Types of postpartum sutures:

1. Internal - located on the walls of the vagina, cervix. Usually performed with self-absorbable threads.
2. External - located on the perineum. They are performed with both self-absorbable and regular threads.

External seams on the crotch

The longest and most painful process in childbirth is the dilatation of the cervix. She needs to go a long way from about 1 cm of dilation (this is how women usually end up in the maternity hospital) to 8–10 cm. The process is accompanied by strong contractions and can last from several hours to several days.

Compared to dilation of the cervix, the birth of the baby itself takes a matter of minutes. At the midwife's signal, the woman begins to push, helping the baby pass through the birth canal, and soon he is born. Attempts take on average from 20–30 minutes to 1–2 hours. This process should not be delayed; it can lead to asphyxia in the newborn. Therefore, when the doctor sees that independent birth is impossible or difficult, he makes an incision.

An incision (episiotomy) is a surgical cut through the perineum and back wall of the vagina. There are perineotomy (incision from the vagina to the anus) and mid-lateral episiotomy (incision from the vagina to the right ischial tuberosity).

For some unknown reason, women in labor try their best to avoid tears and especially incisions. On women's forums you can often find the proud “not torn,” which generally implies that the mother is well prepared, the normal course of labor, the normal size of the fetus and high tissue elasticity. But when the doctor talks about the need for an incision, and the woman in labor actively protests, is indignant and even screams, this is fraught with negative consequences, primarily for the baby.

Possible consequences for the child:

• Damage to the cervical spine.
• Damage to the nervous system due to lack of oxygen.
• Hematomas on the head, fractures and cracks, hemorrhages in the eyes due to excessive pressure on the soft bones of the skull.

An even and neat cut 2–5 cm long will help mother and child get to know each other faster. After childbirth, the doctor will close it with a continuous cosmetic suture, which, if properly treated, heals very quickly, in about a month. After healing, it looks like a thin “thread”, slightly lighter in color than the skin.

It's a completely different matter if we're talking about breaks. Firstly, it is impossible to predict in which direction the fabric will tear and to what depth. Secondly, it has an irregular shape, torn, even crushed edges are difficult to connect as they were. In this case, several stitches are required; in some cases (for third-degree tears that reach and extend to the vaginal walls), general anesthesia may be required.

What are they stitching with?

Episiotomy incisions and minor perineal tears are sutured with self-absorbable sutures. They are much more convenient, they do not need to be removed, and within 2-3 weeks the threads dissolve without a trace (depending on the material!). Small debris and nodules may come out with the discharge and remain on the pad or underwear.

Deep injuries and cuts are sutured with nylon, vicryl or silk threads. The doctor will remove them in 5–7 days. They tighten the wound tightly and ensure good healing.

In some cases (for severe tears), metal staples are installed. They are removed in the same way as nylon or silk threads, but can leave small scars and holes.

Seam care

While you are in the maternity hospital, under the supervision of specialists, a nurse takes care of the suture. It is usually treated daily with a solution of brilliant green. After discharge, you should continue to care for your suture as directed by your doctor. If everything heals well, it is enough to follow the rules of hygiene, wash yourself after each visit to the toilet, do not wear tight underwear, use natural pads, and provide air access. For inflammation and suppuration, the doctor prescribes therapy (levomekol, solcoseryl, and in especially severe cases, antibiotics).

Internal seams on the vagina, on the cervix, on the clitoris

Internal sutures are placed on the cervix and vaginal walls in case of ruptures during childbirth. Doctors say the main cause of injuries is improper behavior of the mother in labor. Early attempts, when the cervix has not yet opened, lead to its rupture. “Aggravating” circumstances are operations on the cervix, age-related decrease in tissue elasticity. Ruptures of the vaginal walls are provoked, in addition to the above reasons, by the presence of old scars, emergency childbirth, and a high position of the vagina relative to the anus. Of course, one cannot deny the possible guilt of the obstetrician - incorrect tactics also lead to injuries.

In some cases, after applying internal sutures to the vagina, mothers complain of pain in the clitoris. The clitoris itself is not sutured, but the seams and ends of the threads may be located next to it, stretching and injuring the delicate area. In general, if the discomfort is too severe, it is best to see a doctor. Gradually the threads will dissolve and the pain will go away.

What are they stitching with?

Internal seams are made only with absorbable threads. The reason is complicated access to injuries. Most often, catgut or vicryl, sometimes lavsan, are used for this. The final dissolution time for all types of self-absorbing materials is 30–60 days.

Seam care

Internal seams do not require special care. It is enough for the mother to follow the doctor’s recommendations, not lift heavy objects, abstain from sexual activity for 1–2 months, and maintain personal hygiene. Be sure to visit the gynecologist at the appointed time, even if nothing worries you, only a doctor can assess the condition of the tissues, the speed of healing and other factors.

Read more about caring for internal and external scars in the article -.

How long do stitches take to heal?

Be prepared for discomfort and discomfort in the area of ​​the incisions and tears for about 2-3 months. The recovery process is individual for each woman, depending on her well-being, state of health, pain threshold, and age. Some people already feel like they were before pregnancy after two weeks, while others need a year or more to recover.

Take your time to return to an active sex life! Restrictions are not the doctor’s whim or his reinsurance, but primarily concern for your health. For 2–3 months after childbirth, sexual intercourse will be painful until the injured area with a fresh scar restores sensitivity.

Something went wrong if:

1. The suture site bleeds after discharge.
2. Even at rest, you feel pain inside, a feeling of fullness (may be a sign of a hematoma).
3. The seam becomes inflamed, discharge with an unpleasant odor occurs, and the temperature may rise.

All these signs, as well as other changes in the condition that seem suspicious to you, are 100% reason to consult a doctor immediately.

Self-absorbing internal sutures

The recovery time depends on the material and severity of the tear. Catgut disappears within 30–120 days, lavsan - 20–50 days, vicryl - 50–80 days. If you feel good, there is no pain or discomfort inside, you are full of strength and energy - everything is fine. Pay attention to your diet, you need to avoid constipation. If necessary, take a laxative as directed by your doctor.

External seams

With proper care and no complications, the sutures in the perineum heal completely within 1–2 months. To do this, the mother should rest more, it is recommended to stay in bed if possible, and maintain hygiene. One of the reasons for frequent inflammation of the external sutures is postpartum discharge from the uterus. Change your underwear as often as possible, provide access to air (if possible, you can avoid underwear, at least at home), use special pads with antibacterial impregnation.

When to remove threads from external seams

Staples and threads are removed 3–7 days after birth, most often on the fifth. The doctor assesses the condition of the woman in labor, the speed of healing and, based on the information received, makes a decision on discharge.

Does it hurt to remove the threads?

It all depends on your pain threshold. The procedure is unpleasant, but quick. If you are afraid of pain, ask your doctor to spray a local anesthetic on the stitch.

When can you stand up and sit down with stitches after childbirth?

For two weeks you can only lie down or stand. Sitting is strictly prohibited! A reclining position, leaning on the headboard of the bed, is allowed. This also applies to check-out; warn your relatives in advance that the entire back seat of the car will be occupied by you and the baby.

Why such strictness? If you try to sit down prematurely, it is possible that the seams will come apart. And this is not only painful, but will also require re-suturing, doubling the wound healing time.

How long do stitches hurt?

Pain, pulling sensations and discomfort from external and internal stitches should go away within two weeks after birth. If three weeks have passed and you still have a lot of pain where the stitches were placed, be sure to tell your gynecologist. Do not delay, in this case it is better to be on the safe side to avoid possible consequences.

Symptoms of complications on sutures after childbirth:

1. Pain (for external seams), sensation of pulsation and twitching inside (for internal seams).
2. Swelling of the suture, suppuration, is often accompanied by a sharp increase in body temperature.
3. Seams coming apart.
4. Continuous bleeding.

If you experience any or all of the symptoms, consult your doctor. Don’t wait, don’t use advice from the internet, don’t trust recommendations from friends and acquaintances. Frivolity is unacceptable here!

The seam has come apart - reasons:

• Mom tried to sit up before her due date.
• Lifted weights (more than 3 kg).
• Returned to sexual activity.
• Accidentally caused an infection in the wound.
• Didn't follow hygiene rules.
• I suffered from constipation.
• She wore tight synthetic underwear.
• Didn't take proper care of the stitches.

The problem can be recognized by a feeling of burning or itching at the suture site, swelling (perineum), pain and tingling, bleeding, increased temperature, and general weakness. What to do? Immediately go to see your doctor, and in especially serious cases, call an ambulance.

"Microlax" after childbirth with stitches

Let us separately dwell on the problem of constipation. Strong efforts during defecation can lead to divergence of the external and internal seams. A laxative will help you, but if you are breastfeeding, your pediatrician should prescribe the drug. Microlax microenemas are suitable as an emergency remedy; they are safe for nursing mothers and will quickly and painlessly solve a delicate issue. They have a mild effect, the result occurs within 10–15 minutes after use.

The stitches hurt

If everything is in order, the healing process is going well, the gynecologist finds no problems, but the stitches hurt - what is the reason? Perhaps you have a low pain threshold, your tissues need more time to heal, or your lifestyle is too active at the moment. In any case, if you are confident in your doctor (it may be worth consulting with another specialist), allow your body to rest a little. You should not return to active training, lift weights, sit on a hard chair for a long time and do daily general cleaning. All this will have to wait.

Does pain occur only during sexual intercourse? This is a temporary phenomenon, try changing your position, use lubricants. Gradually, your body will return to its previous shape and adapt to the changes.

Sutures become inflamed and festered, causes, treatment

Inflammation and purulent discharge appear when an infection enters the wound. It can penetrate both from the woman’s body (postpartum discharge, infections not treated before childbirth) and from the outside, if hygiene rules are not followed. Your doctor should prescribe the final treatment regimen for you.

Drugs used:

1. Anti-inflammatory and healing ointments: levomekol, syntomycin, Vishnevsky ointment and others. They will relieve swelling, have an antiseptic and antibacterial effect, and stop the inflammatory process.
2. Suppositories, in particular, “Depantol”, “Betadine” - accelerate the healing of mucous membranes, treat infectious and inflammatory diseases of the genital area.
3. A course of antibiotics, antipyretic and anti-inflammatory drugs - the doctor will select therapy in such a way that breastfeeding can be maintained.

Suture granulation, what is it, treatment

Granulations are new tissue that grows during wound healing (healthy cells, blood vessels, etc. are formed). Normally, this is a natural process, but sometimes granulations grow at the site of the sutures after childbirth and can cause discomfort and feel like small growths. Treatment is at the choice of the gynecologist. Most often, granulations are removed locally or in a hospital.

Polyps on the suture, what they are, treatment

A polyp usually refers to the granulations or pathologies already mentioned above during the formation of a scar. They can also disguise condylomas and papillomas. They look and feel like strange growths (one or more formations) at the suture site and around it. Treatment is usually surgical.

Seal (bump) on the seam

If a fairly large lump is felt on the seam, the first thing you should do is visit your gynecologist. Most often, a nodule from a self-absorbing suture is mistaken for a lump, which will disappear fairly soon. But there may be other options. In addition to the granulations and papillomas listed above, an abscess with purulent contents may form at the suture site. This is a dangerous symptom that signals improper suturing, infection of the wound, or rejection of the threads by the body. Seek help immediately.

How to speed up the healing of stitches

First and foremost: none of the methods should be used before consulting a doctor!

Avoid wearing underwear, especially while sleeping. If there is heavy postpartum discharge, you can sleep on a special absorbent diaper.

Take care of your diet. You need enhanced nutrition, forget about extra calories for a while. The body has experienced stress and needs healthy, high-quality products.

Perhaps traditional medicine recipes will help you. Tea tree oil and sea buckthorn oil promote the healing of injuries.

When can you wash after giving birth with stitches?

Showering is allowed and recommended after each visit to the toilet. But with a bath, and even more so with a visit to the bathhouse and sauna, you will have to wait a little longer. On average, doctors allow you to take a bath two months after birth, if the healing process is successful, without any problems. You can also focus on your body, if postpartum discharge has not stopped yet, you should not rush to take a bath. The fact is that for a long time after childbirth, the cervix remains slightly open and bleeds, and tap water cannot be called sterile. Bacteria, once in a favorable environment, begin to actively multiply, triggering inflammatory processes in a weakened body.

Cosmetic stitches after childbirth

The cosmetic seam after healing is almost invisible on the skin. He came to gynecology from plastic surgery. Main features: passes inside the tissue, has no visible signs of needle entry and exit.

For cosmetic sutures, self-absorbing threads (lavsan, vicryl) are usually used. It is performed on smooth, neat cuts and passes through the thickness of the skin in a zigzag manner, called continuous.

Caring for sutures - a reminder for a woman in labor

1. Change the sanitary pad every two hours, regardless of the presence of discharge. If possible, avoid wearing underwear.
2. Do not forget about treatment with antiseptics if prescribed by a gynecologist.
3. After visiting the bathroom, take a shower, and if this is not possible, wipe the perineum with a sterile napkin using gentle blotting movements.
4. Do not sit down for two weeks.
5. Monitor your diet, exclude gas-forming and fixing foods (baked goods, cereals, etc.). If necessary, take a laxative and do microenemas in consultation with your doctor.

With proper care, external and internal seams, regardless of the material with which they are made, heal quickly and do not leave large scars. Take care of yourself, follow the recommendations of the gynecologist, and very soon you will be able to return to normal life.