Normal Post-natal Suture Wound Conditions Have Open Flesh And No Suture Thread?
Hello, I would like to ask, I gave birth on October 18, then normally, and was sewn because there was an episiotomy by the midwife, about 2 weeks after giving birth I defecated, because before the control said midwife said the outer stitch was slightly open but the stitches were open the inside is not open and the meat is fused and has dried out so it cannot be sewn back to the stitches that are open a little td, so I decided to defecate squat I thought I could do without asking first when I could squat. Well I still felt pain until yesterday I saw and checked itself it turns out the meat is open and there is no stitching thread, is that really the stitching indeed open because I have squatted up? And is it necessary and can still be sewn again? Thank you🙏
Normal vaginal delivery can cause a tear in the perineum. Perineum is the area between the vagina and anus. Perineal tears can occur naturally because of pressure from the bottom of the baby (head / buttocks) at birth or it could be due to an episiotomy procedure (cutting the perineum) to widen the birth canal.
Perineal tears can occur in several degrees, as follows:
Degree 1: tear around the vaginal skin only
Degree 2: tear the vaginal mucosa to the perineal muscles
Degree 3: tear reaches the anal sphincter muscle
Grade 4: Tear a large area from the vagina to form a relationship between them
Perineal sutures are performed at 2-4 degree perineal tears. Perineal sutures generally use absorbable thread (which can be absorbed by the body and disappear by itself) so there is no need to remove the thread in the future. Perineal suturing generally uses a continuous / continuous sewing method that starts from the mucosa in the vagina and then to the skin.
Patients after perineal suturing will be given antibiotics and pain relief. The use of stool softeners is also justified to prevent the patient from straining too badly during bowel movements. Patients are advised to wear underpants that are not too tight and do not wash the vaginal area with water that is too hot because it can damage the thread. Patients should also avoid sexual intercourse for a while. The function of the stitches is so that the two edges of the wound can meet so that the wound healing process can occur normally and more quickly and give the final result a better shape of the scar. Generally the perineal wound dries within 1 week. Yarn will be absorbed in a variety of times, namely 10-21 days. Wounds that heal longer while the thread is absorbed first cause the wound edges do not fuse.
Sutures can open if the mother often strains in the early days of sewing, the thread quality is not good, the stitches are too tight or loose. The stitches can open and the wound heals for longer if an infection occurs in the wound which is marked by swelling in the wound area, the area of the skin looks reddish and painful, as well as the discharge of pus. Generally, open perineal sutures are not sewn back when the wound is dry because the edges of the tissue cannot be fused / the normal wound healing process cannot occur. Wounds will usually be treated using a normal saline solution to remove impurities from the wound to facilitate healing of secondary wounds and healed wounds without re-sewing.
Dehlicated perineum re-stitching (open stitching) can be done if the wound edge is still "wet", the stitches are open within 3 days after the suture and the patient arrives immediately, extensive tear wounds that will cause ugly scars and poor function if not sewn again , and no infection was found. Perineal re-stitching also requires the approval of the patient because it will definitely be accompanied by pain during the procedure and extra care will be needed afterwards. Thus the explanation from me, hopefully useful.