What is an episiotomy? Features stitches after dissection. What to do for a successful wound healing? How to care for stitches? Complications seams
Episiotomy is an operation during labor,Carried out by an obstetrician-gynecologist. There is a surgical intervention in the dissection of the perineum and deeper lying tissue with a scalpel. This activity is forced and conducted in two cases: when there is a threat of rupture of the perineum due to the too large fetal head; With poor stretchability of the vaginal walls in a woman.
The operation is also performed in case of need to accelerate the birth process, when there is a threat of life for the child or the mother.
How is the procedure carried out?
It is difficult to say before delivery, how likely is this procedure. In the overwhelming majority of cases, it is carried out in the presence of indications and in case of emergency.
The perineum is cut at the time when the headFetus squeezes the tissues of the birth canal as much as possible. Usually it is dispensed with without additional anesthesia: the tissues are compressed, that is, the blood does not flow to the nerve endings, hence, there is no pain impulse to the brain. That is why at the time of dissection, nothing hurts.
The cut made by the specialist is sewn by layer: First, a resorbable suture material is used on the muscles, mucosa and fasciae located between the vagina and the intestine. The skin is sewn with ordinary non-absorbable threads, often with medical silk. In some cases, the doctor can perform a so-called cosmetic suture: there is only the initial and final nodes outside, the rest of the thread is hidden under the skin.
Stitches made with absorbable threads, notNeed to be removed. They dissolve independently 7-10 days after the operation. It should be noted that the resorption time depends on the material selected. But the seams on the very perineum will be removed by doctors in the conditions of a maternity home or a women's consultation.
Features of episiotomy sutures
The main feature, which has seams,Made after an episiotomy, is that they are located in a place where it is difficult to maintain a sterile environment. Immediately after childbirth from the vagina, lochia begins to be allocated, which will be observed from 1 to 1.5 months.
The perineum can not be fixed sterileBandage because of the anatomical structure of this area. In addition, the adhesive does not adhere to the wet skin surface. Proceeding from the above, the seam after the episiotomy requires special care.
What can I do to remove the stitches on time, that is, 5-7 days after the operation?
- Every 2 hours, change the sanitary napkins;
- After visiting the toilet, wash with warm water. You can use disinfecting soap or pale pink solution of potassium permanganate. Wipe the area of the seam with a towel or gauze with soaking movements. Such withdrawal should be both in the maternity home and within 1.5 months after delivery;
- Every day during the stay in the maternity hospital the midwife will process the seams in the gynecological chair;
- You can not take a bath. The ban on such water procedures lasts at least 1 month. Hygienic procedures are carried out in the shower or use a bidet;
- Many women are interested in when you can sit downAfter an episiotomy. This issue is very important, since with the violation of the regime, complications are possible. It is not possible to sit down fully 10 days - 2 weeks after the manipulations. Allowed only a sitting posture on the toilet. Take food or feed the baby can be standing or lying, but nothing else. After about 10 days allowed to sit on a chair with a hard surface. After a while, you can rest on the couch, in the armchair, etc .;
- During the first 3 days you should not eat bread and other pastries. This applies to cereals. The deprivation is aimed at delaying defecation;
- After the woman is discharged from the maternity ward, she can go home in the back seat of the car in a reclining position;
- If there are signs of inflammation, which will be noticeable during the treatment of the suture, the mother gives antibiotics a place, inside and in the form of injections.
The speed of joint healing and sex after episiotomy
How many stitches are made after episiotomy? - Another issue that disturbs newly mums. It should be noted that this process is quite long - it takes about a month and a half to heal. The restoration of the skin is affected by individual characteristics of the body, as well as compliance with the above measures.
When is sex possible after episiotomy? Abstinence should also be prolonged - at least 6 weeks. The first few sexual acts can be accompanied by pain and crotch tension. That's why the partner should be patient and not in a hurry. It is recommended to use a lubricant and give preference to the posture, which allows you to control the woman's depth of penetration.
How to care for sutures after childbirth and what to do if they are concerned?
In the hospital, midwives deal with their treatment. For this, green or manganese is used. In the future, the woman will do it herself at home. It is necessary to carry out the measure after each water procedure.
It is necessary to exercise accuracy in the emptying of the intestine. Do not overload the intergrown tissues. The optimal option for urge in the toilet will be an enema or glycerin candle.
Hygienic gaskets can be replacedDisposable panties made of breathable materials. When preference is given first, the underwear must necessarily be made of natural material, for example cotton.
Also, do not dress right after the shower, becauseAir baths have a good effect on the skin and cuts faster heal. In this case, you can not soak the affected area, but simply wait for it to dry completely.
You can not wear pulling underwear, as the process of blood circulation is disrupted, which negatively affects the healing of wounds.
Complications of postpartum sutures
The main complaint of women is soreness. Normally, the seam applied after the episiotomy, hurts only 2 days. But the discomfort caused by it will last much longer, especially if the woman does not follow the above measures, will try to sit down ahead of time.
If the wound hurts in the sitting position, but you canTolerate is a variant of the norm. Whenever unpleasant sensations overtake in a standing or lying position, it is necessary to consult a doctor. After all, there is an inflammatory process.
In the consequences of episiotomy often involves divergence of seams and suppuration.
In the first case, if the wound is still fresh, the stitchesSuperimposed again. When the incision is already well connected and the entire suture does not part, the doctor often leaves the situation as it is, but only if there is no threat to the health of the woman. If the entire seam diverges, the wound is dissected by a new one and sewn again.
Very often the discrepancy occurs after dischargeFrom the maternity ward. If a woman at home is disturbed by any condition affecting the sutures, she should immediately seek medical help or call for emergency care.
When suppuration, the doctor prescribes additional measures concerning the treatment of damaged tissues. Care is supplemented with tampons with special ointments.
Usually, tools are used that eliminateInflammation and suppuration, for example, Levomikol, Vishnevsky ointment and other drugs with similar properties. If uncharacteristic discharge is detected, it is also necessary to immediately contact a medical institution.