How many days does a suture usually heal after a cesarean section?

Stitches after a cesarean section are an unpleasant and inevitable consequence of a surgical delivery. They do not always look aesthetically pleasing, and besides, they do not always heal without problems and complications. In this article, we will tell you how long it takes for postoperative stitches to heal.

Kinds

The healing mechanisms of the postoperative sutures remaining after the caesarean section depend on the type of sutures, the technique of their implementation and the surgical suture material used in this case.

Since not only the abdominal wall is subject to dissection during the operation, but also the anterior uterine wall, the stitches after obstetric surgery are divided into two main types:

internal;
external.

Internal sutures are applied to the dissected wall of the uterus immediately after the uterine cavity is free of the baby, amniotic sac and placenta. Usually, to apply them, surgeons use single-row continuous suturing and a special type of suture material - threads that do not need to be removed and processed later, since they dissolve on their own as the edges of the wound grow together.

Outside seams are mostly carried out with a knot or stitch method. They use either special medical silk threads, or self-absorbable threads, but thicker than the inner ones, or staples made of a special medical alloy that does not oxidize.

The type of suture depends on how exactly the surgeon performed the cesarean section. If a planned operation was performed, during which no abnormal situations occurred, then the incision usually does not exceed 10 centimeters in length, it is located horizontally above the pubic line. This is called a Pfannenstiel cut. It heals faster and with fewer complications, since the site chosen for penetration into the abdominal cavity is least of all subject to skin stretching and other external influences.

If the operation had to be done for urgent health reasons, then it is possible that the incision will be made vertically - through the navel line to the middle of the pubic zone. This is necessary in order to quickly remove the baby who is in danger of death. This suture is called corporal, it crosses the rectus abdominis muscle, and therefore heals longer and worse.

The horizontal low-lying suture is now cosmetic in most maternity hospitals. It is almost invisible after complete healing and is easily masked by the elastic of the panties. The vertical seam cannot be neat and will be difficult to hide.

How is the healing process going?

The healing process of different types of postoperative sutures is different.

The internal scar is formed longer than the external one, and this is quite understandable if you know what kind of jewelry and painstaking work takes place in the body after suturing the uterus. In the first 24 hours, the edges of the internal wound made with a scalpel stick together due to fibrin threads, with each hour their gluing becomes more and more durable.

6-7 days after the operation, new cells - myocytes, which are structural cells of the uterine tissue - are formed in the scar on the wall of the uterus. Collagen begins to be produced, which gives elasticity to the surgical area. When these subtle processes are disturbed, more coarse connective tissue is formed, due to which the scar becomes insolvent. Then it can be a serious complication of subsequent pregnancy and childbirth.

In total, the initial formation of an internal scar takes about 2 months. Then the process of its development continues, and after 2 years, the scar, if it is quite wealthy, is considered strong and reliable enough to carry the next pregnancy.

External seams heal faster. Sutures placed on a vertical corporal scar can heal up to 50-60 days, and the likelihood of complications is higher than with a small horizontal incision in the very lower abdomen. The suture after the Pfannenstiel section can be removed already on the 7th day, and it takes about three weeks for the complete healing of the surgical area. The external suture heals completely and becomes lighter and less noticeable about a year after the surgical delivery.

Why does it heal badly?

Often, women are faced with the fact that the seams heal slowly, poorly, and certain complications arise. By the time of onset of symptoms, early and late complications are distinguished.

The early ones include a variety of options for infectious inflammatory processes. Caesarean section is always associated with the risk of infection, and there is no escape from this. Our world is inhabited by bacteria, viruses, fungi, some of them can survive even in a clean operating room.

Any inflammatory process will manifest itself as pain, discharge from the scar of the ichor, possibly even pus. Also, most often, a woman has a fever and pain in the scar area.

Excessive bleeding of the scar after surgery may indicate injury to the vascular node at the time of suturing. This can even happen with an experienced surgeon. Such a complication is characterized not only by discharge from the suture of the bloody plan, but also by the formation of hematomas around and on the scar.

Less often, there is a divergence of the superimposed suture. This can happen due to the increased motor activity of a woman at first, due to imprudence, due to the immune rejection of suture material by the female body.

Discrepancies of the inner seam usually occur without any special symptoms, and only when the uterus does part, weakness appears, there may be bleeding, loss of consciousness, drop in blood pressure, tachycardia. The causes of internal complications are the same as those of external ones.

Failure to fully heal the scar can lead to late complications - for example, to the formation of a hernia or to the appearance of a ligature fistula.

Helpful care tips

The stitches on the uterus are not processed. But a woman may well protect them if she does not lift weights, does not start having sex too early, and excludes the penetration of any infection into the genital tract, even with tap water when performing hygiene procedures. In order to avoid infection, in the early period of rehabilitation in the hospital, it is recommended to use not purchased sanitary pads, but exclusively sterile hospital liners. They are changed every 3 hours.

At home, after discharge, a woman can use sanitary pads, but it is advisable to change them every 2 hours in the first week and a little less often thereafter.

Outside seams need maintenance and treatment. In the maternity hospital, this is done by medical personnel, but after discharge it will have to be done at home. Every day it is recommended to dry the scar with hydrogen peroxide, treat the edges with brilliant green, and also continue to wear a surgical bandage until the stitches are removed. After removing the stitches, the recommendations can be individual. If it heals quickly and well, it is recommended to remove the bandage. If there are problems, it is recommended to continue handling and wearing the gauze bandage.

A healed external seam cannot separate, which cannot be said about the internal one. A scar on the uterus, if it is not well-off, can disperse during a subsequent pregnancy and during repeated childbirth. To prevent this, a woman should remember about the prevention of complications from scars:

carry out the processing regularly, if you find any deviations, immediately consult a doctor;
sex after the operation is admissible after cleaning the uterine cavity from lochia - the discharge should stop, but not earlier than 2 months after the operation;
tampons cannot be used in everyday hygiene;
avoid douching;
the subsequent pregnancy should not come too early, the recommended break is at least 2 years;
do not squat, do not jump, do not pump the press if another six months have not passed since the day of the operation.

To make the healed scar look more aesthetically pleasing, after its healing, it is allowed to use the "Contractubex" product, it reduces scars and scars and makes them less distinguishable. But the remedy is effective only for "young" scars that are not yet a year old. Then, to eliminate the ugly scar, you will have to use other methods - laser resurfacing, injection correction, surgical excision of the ugly scar and the formation of a new one. Each method has its own pros and cons.

In practice, it is not often necessary to resort to correction, since cosmetic sutures, which are tried to be applied in a special way even in the maternity hospital, do not cause big problems for their owners at the healing stage.