Lacerations and injuries suffered by women during childbirth cause considerable discomfort and inconvenience. Sutures placed as a result of such injuries require special attention and impose certain restrictions on the daily routine and activity of the new mother. Such seams are not only long time cause painful sensations, but sometimes they can diverge, which provokes more serious problems. How to avoid a situation where the postpartum suture comes apart and what to do in such cases, we will consider in this article.

Prevention of damage to the integrity of the scar

Most often, sutures after childbirth are placed in the perineum, although there are sutures in the pelvic floor, on the uterus after caesarean section, in the vagina, on the cervix, etc. All these seams require careful adherence to the woman’s personal hygiene, as well as very low physical activity. There are cases when such a scar split due to a sudden movement made by a woman or as a result of shifting a child.

• In most cases, the sutures come apart within the first hours after removing the medical threads that held them together. This may be the result of any sudden movement, excessive load on the seam, or an inflammatory process that interferes with good tissue fusion. Sometimes, premature removal of surgical material, when the scar has not yet formed, can also cause problems with the suture. In such cases, the scar itself may not separate, but it will be wide and rough.
• It is considered normal to experience pain in the perineal area while sitting in the first time after childbirth. To reduce them, and also to prevent the scar from spreading, a woman is strictly forbidden to sit for a month after giving birth. Absolutely all procedures, including feeding the baby, eating, pumping, watching TV, traveling in a car or other transport, etc. can only be done in a semi-lying position, without sitting down completely, so as not to load the perineum. The less stress the stitches experience, the faster they will heal. Gradually loading the perineum can begin after four weeks after birth. Moreover, first you should sit on a soft surface, and over time, on a harder one.
• Poor tissue fusion may be caused by the mother's history of diabetes mellitus. If the doctor discovers that tissue fusion does not occur, the woman is hospitalized and further treatment is carried out under special medical supervision.

Unfortunately, in very rare cases, a woman can ensure complete absence of stress and sterility of the suture area.

Lochia released for several weeks after childbirth creates favorable conditions for the development of various pathogenic bacteria.

And the need to lift the baby in your arms for feeding, bathing or swaddling can provoke a violation of the integrity of the scar. A suture placed in the perineal area, due to the peculiarities of its location, cannot be fixed with a sterile bandage, therefore only on our own the woman in labor can control and influence his condition.

Why vomiting occurs during pregnancy and how to deal with it

After cesarean

Sutures after a cesarean section are most at risk of divergence, since they are long and take on the load from almost any movement of the woman, not to mention the excessive weight of the newborn baby.

After surgery, two scars form in the female body: internal and external.

• An internal scar connects the walls of the uterus after the incision is made.
• External connects the walls abdominal cavity.

The suture on the uterus takes a week to form, so the ligatures are removed approximately on the seventh day after birth. If the incision was sutured with self-absorbing threads, the suture is not removed. These threads remain on the wound for approximately 1.5–2 months, reliably fixing the walls of the incision, so such sutures are considered more reliable.

The final formation of a scar on the uterus ends approximately 10–15 months after birth.

A woman who gave birth to a child by cesarean section needs to be periodically examined by the attending gynecologist during this time so that the doctor monitors the process of scarring of the internal suture. For a better examination, you will need to do an ultrasound.

During the first time after childbirth, the internal suture on the uterus causes such severe pain that women in labor are prescribed pain medications. However, over time, these pains gradually decrease.

• It is very important to do regular antiseptic treatment outer seam. The tissues in which the inflammatory process begins and suppuration do not grow together, so the health of the suture is directly related to the rate of scarring. If the doctor detects the process of tissue suppuration, then he carries out drainage to remove the released pus from the wound, and after cleaning the wound, anti-inflammatory treatment must be done.
• In some cases, the inflammatory process in the scar area can be triggered by the individual characteristics of the female body, in particular, an unfavorable reaction to surgical material. In such cases, early removal of the fixing threads is required. After a thorough examination of the scar, the doctor decides on further treatment. In the case of a slight divergence of the seam, special treatment is prescribed, which helps the wound heal faster. In particularly difficult cases, the doctor may recommend re-application of tying threads, but this happens extremely rarely.
• Women giving birth after a cesarean section should carefully follow the doctor’s recommendations regarding the weights allowed to be moved. Under no circumstances should they pick up a child after childbirth if his weight exceeds the permitted 3 kg. Very often, the suture comes apart 2–3 days after the ligatures are removed precisely due to violation of these requirements. Not every mother can show sufficient willpower not to take such a long-awaited baby into her arms. In order to avoid such problems in the first days after childbirth, a woman after a cesarean section needs the help and support of loved ones who can help her care for the child.
• In addition to lifting heavy weights, excessive physical activity, for example, bending over, sharp turns, can provoke scar divergence. Any tension in the abdominal muscles causes a sharp increase in intrauterine pressure. And this, in turn, can lead to divergence of the inner seam. To avoid this, women after a cesarean section should definitely wear a special elastic bandage after childbirth, which will fix the scarring tissue. In the absence of a special bandage, you can make a tight constricting bandage on the abdomen to fix the abdominal tissue. Such a bandage or bandage should be put on by a woman in labor before she gets out of bed in the morning, and worn throughout the entire time she is in a standing or sitting position.

Is it possible to use glycerin suppositories for constipation after childbirth?

Treatment of a broken scar

Painful sensations in the suture area persist for some time after childbirth, but gradually they become less intense.

If the pain does not subside over time, or, on the contrary, becomes more severe, the woman in labor should definitely consult a doctor.

Pain should not be relieved with painkillers. Firstly, such medications can adversely affect the health of a newborn baby if they enter his body along with mother's milk. Secondly, increasing pain can become a symptom of possible complications, the treatment of which is best started as early as possible.

The situation when the internal scar ruptures occurs very rarely. This usually happens when a woman in labor does not follow the recommendations given by doctors upon discharge from the hospital. If a woman lifts weights, does not monitor the condition of her intestines, which complicates bowel movements, and exposes herself to excessive physical exertion, then she increases the likelihood of internal seam divergence.

Only a doctor can determine the condition of the internal seam during the examination of the woman in labor. If there is a suspicion of scar divergence, a woman should consult with her doctor. Symptoms of the problem may include:

• tissue redness,
• increased pain,
• bleeding,
• the appearance of swelling at the scar site,
• increase in body temperature,
• the appearance of unusual discharge.

If these symptoms appear, a woman should consult a doctor as soon as possible and have the condition of the scar examined to exclude the possibility of developing dangerous diseases, for example, endometriosis.

Depending on the degree of violation of the integrity of the suture, the doctor prescribes a specific treatment.

• If the wound has not yet healed and the stitch has already come apart, the doctor will reapply it.
• If not the entire scar has come apart, but only a few of its stitches, then perhaps the doctor will not do anything, but will leave everything as it is, if such a situation does not pose a danger to the woman’s health.
• If about a year or two has passed since the birth of the baby, but the suture is severely torn, then re-dissection of the scar tissue and re-suturing will be required.

A little about stitches after childbirth and how to heal stitches on the perineum faster

Before discharging a woman from the maternity hospital, the doctor must examine the sutures and make sure there are no inflammatory processes that could affect the healing process of the scar.

If a process of suppuration occurs in the perineal area, local treatment can be prescribed, which involves treating the suture and adjacent tissues with antiseptic drugs, as well as the use of special healing ointments.

Fucorcin, brilliant green solution, iodinol and other drugs can be used as antiseptics.

It is recommended to treat a wound without an inflammatory process, in the absence of purulent discharge, with levomekol cream, which promotes faster healing of the wound. Preparations based on panthenol will help speed up the process of scar regeneration, sea ​​buckthorn oil or milk thistle oil, which heals the wound and absorbs scar tissue well.

The happiness that engulfs a woman cannot be expressed in words; all the pain, all the torment experienced just a few minutes ago is forgotten. But in order to calmly hold the baby in your arms, you will have to work a little and suffer.

The most unpleasant, painful and long time takes first when the cervix dilates. But the second one - the birth of a baby - is a matter of minutes, which, however, can be overshadowed by or (even worse) a rupture of the perineum. Some women resist the cut as best they can: they are indignant and even scream. But you need to understand that this manipulation is sometimes simply necessary.

The birth canal may be narrow for the baby, and if the doctor does not make the incision, the child himself will do it. Then it will already be tear with torn edges irregular shape , and it will be quite difficult to sew it up, not to mention the fact that it will heal for a long time and painfully.

But the cut made with a scalpel is smooth and neat, will allow just a few stitches to bring the edges together. Such a seam will heal quickly and will not cause much trouble if it is properly cared for and treated.

External (external) and internal sutures after childbirth

Internal seams are applied when the cervix and vaginal walls are ruptured. Since the cervix loses sensitivity after childbirth, When stitches are applied, the woman in labor feels almost nothing.

But when stitches are placed on the vagina, this is quite noticeable, so local anesthesia is given. Internal seams are made with self-absorbing threads, which do not require additional care or removal of seams.

To external seams include stitches on the perineum, and here everything is a little more complicated. A woman can tear on her own and the stitches on the tears take longer to heal.

However, Mostly doctors manage to make an even (and absolutely painless) incision towards the anus. Putting stitches in this place is a little painful, so local anesthesia is given here too.

You should take special care of the sutures in the perineum after childbirth, because this is a place where you cannot apply a sterile bandage, and the sutures come into contact with the external environment and can easily become inflamed.

Self-absorbing sutures

Recently, almost all stitches are applied using self-absorbing threads. This is very convenient: you don’t need to remove them, and already in 7-10 days there will be no trace left of them.

The only thing a woman can notice is pieces of threads or knots on the pad. Don't be alarmed, know that these remnants of thread mean that the stitches have almost dissolved. In a month, during an examination with a doctor, you will be able to verify this.

Let's look at some features

In order for the stitches to heal quickly and not become inflamed, they need to be properly cared for. Internal seams during normal course are not processed at all, since sterile self-absorbable sutures are used. There is enough hygiene care here.

But if the internal seams are inflamed or festered, then use tampons with levomikol or any other anti-inflammatory ointments.

External seams require special care.. They should be processed 2 times a day. In the maternity hospital this is done by a nurse.

First, the seams are treated with hydrogen peroxide, and then brilliant green or iodine. In addition to this, physiotherapy procedures are carried out to promote speedy healing.

The woman in labor should change sanitary pad every 2 hours, in the maternity hospital they use sterile disposable panties. You should wash yourself at least 2 times a day and after each act of defecation (and do this long after discharge). After washing (with potassium permanganate), the seams should be carefully blotted with a towel., but under no circumstances rub it with it, then treat it with peroxide, and then brilliant green or iodine.

A woman always has a lot of troubles after giving birth. And problems with seams are only a small part of them. But believe me A healthy baby snoring sweetly in your arms will atone for all your hard work and make you forget about all the difficulties associated with childbirth.

Many women who encounter stitches for the first time after childbirth do not know how to behave correctly so that the seams do not come apart.

The most important thing is a woman in labor with stitches should not sit for 7-10 days no way. That is, eating, feeding the baby, swaddling and doing other work can only be done while lying down or standing.

At first it will be difficult to get used to this, and the desire to sit down will appear all the time. It is important not to do such a stupid thing, otherwise the seams will come apart.

Previously, it was much simpler, because the baby was brought only for feeding and immediately taken away, so the woman in labor could rest and get used to her new position. Women in labor with stitches were generally forbidden to stand up unless necessary, which is why the healing of the stitches after childbirth occurred much faster.

But now, when the baby is brought in on the first day and left with the mother until discharge, observe bed rest It’s quite difficult, because you need to get up and swaddle the baby, wash it, and feed it. Well, how can you not forget and sit down out of habit?

Remember: you will be able to sit down no earlier than after 10 days (and this is provided that the stitches heal well without causing complications), and then only on a hard chair, and after another 10 days - on easy chair, bed or sofa.

Since the woman in labor is being discharged for 5-7 days, then the trip home will not be very comfortable, you will have to ride in a reclining position in the car. Warn your relatives in advance that only one passenger can travel with you in the car, since you will need more space.

There is one more point: in the first week after suturing, you need to go to the toilet correctly “in large quantities”. It is best to give an enema at the first urge, otherwise the sutures may also come apart due to tension in the pelvic muscles.

What to do if...

The seams have come apart

If the seams do come apart, it is important to determine this quickly.

Internal seams come apart in very exceptional cases. It is simply impossible to notice this on your own. This can only be seen by a doctor during an examination. Such seams, as a rule, are no longer touched.

This most often occurs with external seams in the crotch.. Sudden movements, improper defecation, or if a woman sits down can cause the stitches to come apart.

If this happens literally the next day after birth, then repeated stitches are applied. It’s a different story if the edges of the wound have already healed and the stitches have come apart. Then the doctor decides on re-suturing.

If it is just a couple of stitches and there is no threat to life, then the seams can be left as they are. But it also happens that the seam comes apart completely. Then the edges of the wound are excised and the sutures are reapplied.

While the woman is in the maternity hospital, the doctor examines her every day, and if he finds that the seams are starting to come apart, he will take action. But if after discharge the young mother feels that the stitches have come apart, then she should immediately contact antenatal clinic, where the gynecologist after the examination will tell you what to do.

The stitches hurt

The stitches may hurt for the first couple of days, then the pain should go away. Internal stitches heal much faster, and the pain is felt weakly, going away after a couple of days. But the external seams can bother you for a long time if you do not follow the regime.

Painful sensations when trying to sit down are quite natural, but if the pain appears in a calm state, this may signal an inflammatory process.

That's why you must not endure the pain, but consult a doctor. If you manage it in time, the inflammatory process can be easily eliminated, but if you delay it, the stitches will fester, and treatment will have to be long and tedious.

When are sutures removed?

The situation is more complicated with ordinary stitches that need to be removed. This can only be done after the wounds have healed. IN best case scenario this happens on day 6-7.

But if the sutures become inflamed after childbirth or the sutures fester, then healing is delayed and you have to fight the inflammatory process and only then remove the sutures.

So when are stitches removed after childbirth? All this is decided individually. Before being discharged from the maternity hospital, the woman is examined by a doctor and, if all is well, the stitches are removed (the process is almost painless). If it’s too early, the doctor will tell you when you need to go for a consultation.

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

If the incision is made towards the anus, the dissection procedure is called perineotomy

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. 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 synthetic threads, soaked in 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?

For suturing, self-absorbable materials or threads that require removal can be used

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 physical activity 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 seam looks solid, but there are small areas 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 individual characteristics 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

Most often, the seam begins to diverge at the end of the incision.

Internal seams come apart quite rarely. This can happen if the body rejects suture material in case of 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. Medicinal composition soak the gauze pad and fix it 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; it does not lose its position, despite active development pharmacology. 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 processing 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. Side effects have not 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, 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 one, 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 also 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

To prevent the sutures from coming apart in the first days after childbirth, the woman is recommended to go to bed.

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 the bed, sofa, pillow.

Possible negative consequences and complications

Pain, physical discomfort, development of infections - possible complications after suture dehiscence

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 with the help of plastic surgery. In the postpartum period, it is necessary to closely monitor your well-being and appearance seam Let's list the possible negative consequences from seams coming apart.

There are a number of circumstances why a woman needs stitches during childbirth. If you follow certain measures, the stitches will heal quickly and will not come apart.

Situations in which stitches are used

When childbirth takes place naturally, situations may arise that simply require stitches. Firstly, the birth sutures may be too narrow for the baby to fit through. So you have to expand them using a cut. And if not the doctor, then the child himself will do it. In the latter case, you will end up with an irregularly shaped tear that will be difficult to stitch up and will also take much longer and be more painful to heal. If a doctor makes the incision, then such a suture will heal much faster and more painlessly. And if you take proper care of it, the seam will quickly heal without causing any trouble to its owner.

The doctor makes an incision in the perineum in the following cases:

• premature birth;
• rapid labor;
• breech presentation of the child;
• the presence of a scar from previous births, inelasticity of tissues;
• threat of perineal rupture;
• contraindications regarding pushing during childbirth.

All of these reasons have only one goal - to make it easier for the baby to pass through the cervix in order to avoid injury to the baby’s head. In the case of an incision in the perineum using a scalpel, the healing of the sutures occurs faster and better than with natural tears in the muscle tissue.

If the baby is born by caesarean section, the suture is located on the front abdominal wall.

Healing of postpartum sutures is a fairly long process of restoring soft tissue in the perineal area. Used various materials, the choice of which depends on the indications and circumstances.

Today the following types of materials are available:

• synthetic and natural self-absorbing;
• non-absorbable;
• metal brackets.

Usually, when the sutures dissolve on their own, the wound heals within 1.5-2 weeks. The sutures themselves dissolve in about a month. As for other materials (non-absorbable, staples), they are removed approximately on the fifth day, depending on the size and cause of the suture.

To speed up the healing of sutures and prevent their divergence, as well as reduce pain and avoid infection, it is necessary proper care behind it and compliance with certain rules.

If there are stitches on the cervix and vaginal walls, it will be enough to follow normal rules hygiene. There is no need to care for the sutures, as they are sewn up with self-absorbing threads and heal on their own.

In the first days after birth, the sutures on the perineum are treated by a nurse twice a day, usually using “brilliant green” or a “potassium permanganate” solution. The material used is usually self-absorbable. The nodules of these threads fall off on their own in about 4-5 days.

At home, it is enough to follow the usual rules of personal hygiene:

• change gaskets as often as possible;
• It is advisable to use disposable panties or loose cotton underwear;
• during the healing period of the suture, do not wear figure-shaping underwear, as blood circulation is disrupted, preventing wound healing;
• you should wash yourself twice a day (morning and evening), and only using baby soap;
• after water procedures, the seam should be dried with a towel, blotting it with a towel.

You should know that a woman who has stitches in the perineum after childbirth is absolutely not allowed to sit down in the next ten days. With the exception of going to the toilet, where you can sit on the toilet within the first day after delivery.

Usually, before giving birth, a woman is given a cleansing enema. Eating during childbirth is also not allowed. Therefore, stool appears approximately on the third day after birth. To avoid constipation, you can drink one tablespoon before meals. vegetable oil. Then the stool will be softer, which will not affect wound healing. It is also not recommended to eat foods that have a fixing effect.

While the woman in labor is in the maternity hospital, all treatment of sutures after a caesarean section is undertaken by the medical staff. The sutures are treated with antiseptic solutions, changing the bandage periodically. A woman should only carefully take care of the sutures after surgery. A scar on the skin takes about seven days to form. As for the material used for suturing, the threads dissolve on their own in about 2-3 months.

Caesarean section is quite serious surgery, during which an incision is made into all layers of the anterior abdominal wall. The woman in labor will be bothered by pain in the suture area, so in the first days an intramuscular painkiller is administered. In addition, it is recommended to wear a postpartum bandage and not lift anything that weighs more than the weight of the child.

If this happens, you should determine it quickly and take urgent measures. The seams inside very rarely come apart, and it is extremely difficult to determine this yourself. Only a doctor will see this during an examination. Most often, the seams diverge in the perineal area. And the reason can be very banal - an incorrect act of defecation, a woman sitting down, lifting a heavy object or a sudden movement.

If the sutures come apart on the first or second day after birth, the sutures are reapplied. If a couple of stitches diverge without a threat to life, the seams can be left as is. But the woman is monitored while she is in the maternity hospital, and if the stitches come apart at home, she urgently needs to seek help.

Signs of seam dehiscence:

• pain;
• redness;
• discharge;
• other external signs.

Depending on the complexity of the situation, for example, in the case of suppuration of a wound, the doctor prescribes local treatment. In case of purulent-inflammatory complications, it is necessary to treat the sutures using Vishnevsky ointment or syntomycin emulsion. After the wound has been completely cleaned of pus, levomekol will usually be prescribed, which speeds up the wound healing process.

Compliance will help avoid complications simple rules hygiene and medical recommendations.

Waiting for the birth of a child is a magical time, but some women face various complications during labor that overshadow the first days, weeks and even months of motherhood. If during the process of delivery the tissues of the perineum, vagina or cervix are torn or cut, immediately after the baby is born, the obstetrician-gynecologist resorts to using a needle and suturing the wounds. But this imposes additional restrictions on the young mother, because the seams cannot be allowed to diverge.

Dehiscence is a complication that occurs after childbirth

In most cases, sutures heal after childbirth without causing any unpleasant consequences. But sometimes complications are possible - separation of the edges of the wound, which leads all women into a depressed depressive state.

Seam dehiscence after childbirth is the cause of tears and depression for many young mothers

Reasons for discrepancy between internal and external seams in a nursing mother

The reasons for the discrepancy between external and internal seams are similar:

• lifting weights;
• sudden movements;
• failure to comply with the terms of the ban on sitting down;
• constipation, which causes excessive pressure on the tissues of the vagina and perineum;
• wearing shapewear;
• early return to sexual activity;
• infection as a result of neglect of personal hygiene.

Thus, the divergence of the seams, as a rule, is caused by the careless actions of the woman herself.

If the internal seams have come apart

As practice shows, internal seams very rarely come apart. But if this happens, the woman will notice the following changes.

1. Increased pain.
2. Changes in the nature of vaginal discharge, in particular, the appearance of blood or pus (if the cause of the suture dehiscence is a bacterial infection).
3. Swelling and redness of the tissues of the genital organs.
4. Increased body temperature.

If the above-described signs appear, it is necessary to consult a gynecologist as soon as possible, because suture dehiscence can only be determined during examination on a gynecological chair.

The discrepancy of internal seams can only be determined by visiting an obstetrician-gynecologist.

How to determine the divergence of external seams

The same signs as internal ones indicate the divergence of external seams. The difference is that a woman can detect the problem herself by visually examining the perineum.

Most often, separation of the external seams is observed after the threads are removed, so the young mother needs to be careful and be attentive to herself in the first days after the procedure.

Experienced midwives, when the seams come apart, recommend that a woman completely abandon pads in favor of a sterile piece of cotton fabric. Personal hygiene products sold in stores do not allow air to pass through and create a kind of greenhouse effect, which does not contribute to the contraction and healing of wounds.

Consequences of divergence of external seams

Dehiscence of external seams does not pose a threat to a woman’s life. However, this unpleasant circumstance increases the healing time of the wound, can lead to infection, and causes the formation of scars and unsightly scars. Sometimes the divergence of the edges of the wound leads to an increase in the entrance to the vagina, which subsequently reduces the quality of sexual life.

To solve some problems, they resort to plastic surgery, reducing the entrance to the vagina and removing unsightly scars. But after such operations, natural childbirth becomes impossible, because, despite the external beauty of the genitals, there is a lot of inelastic scar tissue in the perineal area.

In what cases are the seams re-sutured?

There are two types of seam divergence:

• complete;
• partial.

As a rule, in case of partial divergence, when one or two stitches have come apart, the wound is not re-sutured. The woman is prescribed antibacterial and healing ointments (Levomekol, Vishnevsky). For internal injuries, they are applied to a homemade tampon and inserted into the vagina overnight; for external injuries, they are soaked in a bandage and applied to the perineum.

In case of partial suture dehiscence, re-suturing is not necessary.

If the dehiscence is complete, the need for re-suturing is determined based on the condition of the wound. In some cases, needles are used two to three months after birth, when lochia stops. If the doctor does not see the need for this, he recommends the young mother use ointments.

How to avoid seams coming apart

You can avoid seam divergence if you follow everything learned from medical personnel Recommendations for caring for the sites of ruptures/incisions and the behavior of the woman herself.

1. A young mother should avoid physical activity, do not lift heavy objects, even a newborn should be held and placed in the crib with caution and without sudden movements.
2. You should not return to sexual activity too early. As a rule, two months are enough for healing, but if the doctor recommends avoiding sexual intercourse for a longer time, you should listen to him.
3. It is important to eat in a way that prevents constipation. To do this, you need to drink more fluids, reduce or completely eliminate fastening foods from your diet ( white bread, rice, potatoes), give preference to vegetables and dishes containing a lot of dietary fiber.
4. It is not recommended to sit down earlier than recommended by the doctor. If a specialist says that you can’t sit down for two weeks, then there is a need for it. The inconveniences associated with the ban are less burdensome than the problems that arise when the seam diverges.
5. Personal hygiene must be strictly observed. Pads should be changed every two hours, and washed after each visit to the toilet, because lochia is nutrient medium for the reproduction of pathogenic microorganisms.
6. You need to give up shapewear. It creates excessive pressure on the pelvic organs and perineum, which can cause the seams to diverge.

Taking care of yourself will help prevent troubles associated with sutures coming apart after childbirth. But even if this could not be avoided, do not despair. The help of specialists and the use of healing ointments will promote tissue scarring. And although the recovery period will last longer than usual, in the end all tears and cuts will definitely heal, because female body endowed with enormous power of self-healing.