How long does it take for stitches to heal after childbirth and what does it depend on? How and with what to process them?

Not all births go smoothly. Sometimes it does not do without breaks, and often, for the baby to be born, surgery is required at all. It is clear that a violation of the integrity of tissues - spontaneous or surgical - requires suturing. It is the stitches after childbirth that raise many questions about care, possible problems and ways to solve them. How postpartum sutures heal, what affects this process and how to take care of them, we will tell in this material.

When and how is it applied?

The need for suture placement arises when the integrity of the tissues is compromised. With natural childbirth, in the process of giving birth to a baby, a discrepancy between the size of the head and the genital tract may occur - then an artificial incision in the perineum will be required. Errors in the persistent period can lead to ruptures of the cervix, vagina. Perineal tears can happen spontaneously. To prevent them, doctors may cut the perineum. This procedure is called an episiotomy.

After the baby is born and the afterbirth (placenta) is born, doctors must conduct an audit - they examine the cervix for possible ruptures, assess the condition of the vagina and external genitalia. If there are internal tears, sutures are applied to the cervix, the damaged walls of the vagina are sutured. Applying anchoring stitches after an episiotomy is called an episiorrhaphy. Sutures are always applied using anesthesia - local or general (if we are talking about extensive gaps in the internal location).

Internal sutures are applied with self-absorbable sutures using several surgical techniques that ensure reliable and precise contact of the wound edges. Such surgical material does not require maintenance, it is not removed after healing is complete. It resolves itself over time, only a small scar remains on the internal tissues.

External tears on the perineum and labia are usually sutured with a nodular technique using strong non-absorbable sutures, which after a while, when the edges of the wound heal, must be removed. They need proper and thorough care.

When performing a cesarean section, a woman also has two types of sutures - internal, fixing the edges of the incision on the wall of the uterus, and external - on the skin of the abdominal wall. As in the case of physiological childbirth, internal scars do not need care, they heal and dissolve on their own, but external scars require attention and care.

Recently, the sutures after surgical delivery, and the sutures after a rupture or episiotomy, doctors are trying to make cosmetic - a special suturing technique makes the healing process faster, and scars, which in any case remain, less noticeable.

Why do they hurt?

Regardless of the method of delivery, in violation of the integrity of tissues, nerve endings and deeper layers of tissues are damaged. It is with this fact that any pain in the area of sutures after childbirth is associated, as well as a wide range of other sensations.

At first, the seams hurt, especially when moving. Women after a surgical delivery experience more severe pain, since the area of the surgical intervention is wider - the incision for caesarean on the abdomen is approximately 10 centimeters long. In the perineal region, the incision does not exceed 3 centimeters if an episiotomy has taken place. In the event of a spontaneous rupture, its length and shape may be different.

The stitches that were imposed, in the first few days, are stretched when moving, creating discomfort. But after a week, they practically stop hurting, because when the integrity of the damaged tissues is restored, the primary restoration of the nerve endings also occurs. But other sensations appear - it seems to a woman that they itch, pull, pinch, itch.

In many ways, the intensity of pain depends on how high the woman's susceptibility to pain in general. Some have no painful sensations in the suture area after two weeks, while others have discomfort for six months after the birth of the baby.

Does it hurt to remove stitches is a question that worries every woman in labor who has them. External sutures after natural childbirth are removed depending on the rate of healing, usually after 8-10 days. The stitches after cesarean section are removed on the 7-8th day after the operation. In this case, there is no acute pain, there is only a slight "tingling" in the area from which the suture stitch is extracted. Usually, minor discomfort disappears within 2-3 days after removal.

Separately, it should be said about the restoration of sensitivity. Slight numbness in the area of postpartum sutures is observed both after natural childbirth and after cesarean section. This numbness is associated with a violation of the integrity of the nerve endings. Usually, the numbness goes away within six months or a year.

After natural childbirth

The need for overlapping stitches often arises, because the birth itself is an unpredictable process. Sutures after physiological childbirth through natural pathways have their own characteristics and require special treatment.

What are they?

In fact, a woman cannot feel the internal seams (on the cervix, on the wall of the vagina). The stitches on the mucous membrane do not bother the new mother, which cannot be said about the outer stitches. If the perineum was dissected, the suture can be either vertical or with a deviation to the right or left. The first method of dissection is called median-lateral, and the second is called parineotomy.

Depending on what material is chosen for suturing an incision or tear, it largely depends on how and how long such a suture will heal. The method of dissection itself does not have a significant impact on healing issues. But the technique of suturing is very important - the Shute method (with silk threads through all layers in the shape of the number "8") often leads to complications than layer-by-layer, longer, but more thorough suturing of damaged tissues with different types of suture material with a final cosmetic "touch" ... These sutures look more aesthetically pleasing and heal more quickly.

How much do they heal?

Sutures after physiological childbirth heal faster if they are properly and carefully treated. In the absence of complications, the edges of the wound grow together in 5–7 days. In another day, two of them can be removed.

Understandably, the desire of the newly-made mother to quickly get rid of the threads in such a piquant place, which seriously complicate her life. To promote faster repair of damaged tissues, a woman should pay special attention to issues of intimate hygiene. Lochia is released from the genitals after childbirth. Postpartum discharge is especially abundant in the first 3-5 days after the baby is born. The blood environment of the lochia is optimal for the reproduction of bacteria, and the suture area in the perineum will be in constant contact with the lochia. In addition, it is more difficult for a wound to dry out, since a woman has no way to leave it open for contact with air - she needs to wear a pad.

They will heal faster if the postpartum woman changes the liner more often, using exclusively sterile liners in the first few days after birth. After visiting the toilet, be sure to wash yourself, blot the seams gently with a clean towel or dry napkin and immediately change the gasket.

Sitting is not recommended if a median episiotomy was performed (the incision is directed perpendicular to the anus); with a median-lateral incision (the most common variant), the woman is allowed not to sit, but slightly sit down on the thigh, which is opposite to the incision line. You will temporarily have to take care of the child while standing and lying down. Following this recommendation for a minimum of 2-3 weeks will help prevent tearing and damage. You can sit in the usual position no earlier than 3-4 weeks.

The rate of healing is also influenced by the condition of the mother's blood. If there are no problems with hemostasis, then wounds usually heal more quickly and are less likely to become complicated. To increase the density of blood, it is important to add buckwheat porridge, boiled red meat to the diet and avoid fried and salty, bakery and flour products.

You cannot strain the perineum (pushing in the toilet, walking at a brisk pace) until the stitches are completely healed and removed. Failure to comply with these recommendations will inevitably lead to the development of complications.

Possible complications and consequences

Unfortunately, suture sites do not always heal without unpleasant consequences and complications. Both rupture and surgical incision are forms of trauma, and therefore the likelihood of complications exists.

A woman can understand that healing is proceeding with impairments and deviations if the healing time is violated in a big way. The formation of a dense bump in the area of the seams is a very unpleasant sign, which may indicate that the edges of the wound during suturing were docked carelessly, incorrectly, hastily. If layer-by-layer suturing has taken place, then the seals on the suture can be a sign of inflammation of certain inner layers, the formation of hematomas on the mucous membrane.

If the wound heals after childbirth for a long time, then with a high degree of probability there is one or another complication. A woman should pay special attention to symptoms such as suppuration of the seam, discharge from it. An infected wound festers, and therefore a woman must undergo a course of treatment to cope with the infection. If the discharge from the genitals takes on an extremely unpleasant odor along with poor healing of the sutures in the perineum, you should also consult a doctor.

If the labia looks asymmetrical, it is possible that there is an overlay error, which now manifests itself by excessive tension on one side. If the seam suddenly begins to hurt more, you cannot leave it unattended.

Swelling, puffiness and slight redness may well be present, but only in the first days after childbirth. If these phenomena persist even after a week or two, this cannot be considered the norm. A mandatory visit to a gynecologist is also required by an increase in temperature, soreness and difficulty in urinating, as well as a divergence of the threads.

Discrepancy may be indicated by the resumption of bloody or serous discharge from the suture. If such weeping areas are detected after the surgical sutures have been removed, they are most often left alone, the wounds tend to heal later by the method of secondary tension. If the seam is completely open, the stitches are broken over a larger area, and the seams may be reapplied.

The stitches in the perineum are in the immediate vicinity of the anus and urethra, and therefore the likelihood of inflammation due to infection with intestinal bacteria is always higher. If the pain persists for a long time, the stitches are bleeding, the scar festers and becomes inflamed - all these are unconditional reasons for seeking medical attention. Such problems are not treated independently at home.

Most often, women with stitches after childbirth are worried about how to have sex, what problems may be associated with this. Many people note that sexual intercourse even 2 months after childbirth causes certain painful sensations. This phenomenon in medicine is called "dyspareunia". With this consequence, you will have to temporarily come to terms, since neither intimate lubricants nor other methods bring significant relief. Gradually, the seams soften and become more elastic, and the unpleasant painful sensations disappear. Usually by six months after giving birth, there is no trace of dyspareunia.

Care and handling

Considering all of the above, it becomes clear why special requirements are imposed on the treatment of sutures after physiological childbirth and why it has such a significant effect on the rate of recovery. In the maternity hospital, the stitches in the perineum are processed by the medical staff. Once a day, women are advised to lie with an open crotch under a germicidal lamp. Most of the problems do not happen in the hospital, but at home, when care becomes a personal matter for the mother.

Houses can be washed with a weak solution of potassium permanganate. It will help dry the wound. This procedure should be carried out no more than 1 time a day, excessive use of potassium permanganate can provoke excessive dryness of the external genital organs.

Wipe the crotch is prohibited. You can only lightly blot it with a soft cloth or diaper. Every day, the seams are treated with brilliant green, since this antiseptic is active against the most dangerous bacterial pathogens - staphylococcus.

It is recommended to bathe in the shower in the first month after childbirth, and wash in a bidet. It will be possible to bask in the bathroom later, when all the seams heal and the likelihood of infection of the wound with microbes from the water disappears.

At home, in order to exclude tears, tears of the seam, discrepancies, it is important to avoid constipation, for which a woman should eat right and, if necessary, use approved laxatives. For a more aesthetic formation of scars approximately 4 weeks after childbirth, when the sutures have already been removed, you can start using "Contractubex". An important condition is that there should be no complications.

After a cesarean section

The internal seam after a cesarean section, as already mentioned, does not need care. But a woman should remember about the likelihood of violation of its integrity if the doctor's requirements are not followed. But the external one will require both care and observation.

Kinds

The seam on the abdomen can be horizontal or vertical. In the first case, the incision is made in the lower abdomen, almost above the line of the pubic bone. This method is called Pfannenstiel section and this is how up to 90% of all caesarean section operations are performed. A vertical seam extending from the navel downward or even extending over the navel is called corporal. It is used only for health reasons, when the surgeon needs to get faster and more extensive access to the abdominal cavity in order to save the child's life. Basically, such a dissection occurs during an emergency cesarean section, but this is not always the case.

The Pfannenstiel suture looks more accurate, it heals faster, less often complicates, does not spoil the appearance of the abdomen. The vertical one looks rough, and due to the inconvenience of location, tension and muscle tension, it often becomes more complicated and hurts longer, the need to anesthetize it remains longer.

Internal sutures on the uterus usually heal within 8 weeks, complete formation into a full-fledged and wealthy scar is completed by the end of the second year after surgical delivery. The external one heals at a rate proportional to the suturing technique, the materials chosen, the accuracy of the surgeon's actions, and the presence or absence of complications. Correct care plays an important role in this case too.

The vertical corporal suture heals in about two months, sometimes longer. Horizontal in the lower abdomen - up to 20 days. When cutting along the Pfannenstiel, the threads are removed already on the 7-8th day, and after that the formation of the external scar continues for about two more weeks.

Possible problems

Complications can be early and late, can be found in the hospital, and can become evident only after discharge.

The early ones include infectious processes. The seam becomes inflamed, turns red, bloody or purulent discharge is possible from it. At the same time, the body temperature almost always rises, the scar becomes hard and very painful, swells.

Increased scar bleeding may occur due to surgical vascular damage, due to the formation of hematomas in the area of scarring.

Seam divergence at an early stage is rare. Basically, it can be fixed as a result of a long and painful healing of an infected wound. In some cases, the woman develops an immune reaction to the suture material, which is manifested by the rejection of the threads.

Late problems with a suture after an operative delivery include the formation of an inconsistent internal scar on the uterus, ligature fistulas, and the formation of hernias in the suture area.

Care and handling

Proper processing of the external sutures will help facilitate the healing process. Internal self-absorbing ones usually disappear within a week after childbirth and no longer require observation.

In the maternity hospital, it is customary to process the outer seam once a day with brilliant green. The same regimen must be followed at home, after discharge. To do this, brilliant green should be applied with light movements with a cotton swab around the seam. Before removing the stitches, you need to continue changing the surgical dressing on the abdomen every day, leaving the stitch open for 30 minutes a day. This will help the wound dry out faster.

The stitches heal faster if the wound is treated with hydrogen peroxide before applying brilliant green. You just need to drip a little on the seams, they “hiss” for a while and this is completely normal, and only then smear with brilliant green.

After removing the stitches, if there are no complications, a woman can also use Kontraktubeks gel in order to promote a more even scar formation (as women themselves say, “heal the scar”). The outer scar from this, of course, will not dissolve, but there is a possibility that it will be less noticeable.

Suture care also includes recommendations not to take a bath for 2-3 months, limiting yourself to bathing in the shower. It is better not to wet them before removing the stitches.

A woman should avoid wearing underwear models for six months, which will squeeze the scar area with their elastic band. The seam must not be rubbed, scratched or washed with a coarse washcloth.

Useful Tips

And with stitches after natural childbirth, and with stitches after cesarean, a newly-made mother should remember that the very fact of having stitches requires her to strictly follow all medical recommendations, a list of which she will receive when she is discharged home with the baby.

It is important to competently and correctly build a regimen of your physical activity, to prevent heavy lifting and sudden movements. But leisurely walks in the fresh air will only come in handy - they will help the whole body recover faster, the processes of tissue regeneration will also begin to proceed faster.

The drugs that should be kept in the home medicine cabinet and which can be useful in eliminating certain problems with postpartum sutures are quite simple and affordable. It is better to worry about them in advance. So, you need to get a first aid kit, where there are such drugs:

"Levomekol" - antibacterial and anti-inflammatory ointment, which in case of inflammation of the sutures in the perineum can be applied to a sanitary napkin.

"Bepanten" - a remedy that should not be applied to the stitches after a cesarean section, but after physiological childbirth, it may well relieve the unpleasant sensations of tension after removing the surgical sutures.

"Miramistin" - a universal antiseptic.

Zelenka and hydrogen peroxide, sterile surgical dressings made of gauze and a bactericidal patch.

Any of the medicines, except for brilliant green and peroxide, must be used with the permission of a doctor. "Miramistin" can be used fearlessly to prevent many local inflammatory processes, since it does not provoke any reactions in the body.