Parineum To Anal Stitches?
MLM … I have complaints that my stitches are getting close to the anus, when the chapter was difficult the stitches were loose, then 1 month more now the wound was blistered and the skin was red as if it was really sore when I used it … how come I have to sew it repeat … but I want to sew it again because the distance between the vagina and the anus is very close n I am afraid of the chapter … Please explain me dokTrmksh
Hello Fikri Rikudou Alhamid,
Perineum in women is the area between the anus and vulva (the area that covers the outside of the vagina and also covers the urinary / urethral). The process of giving birth can cause sores or tears in the vagina and perineum. Perineal tears occur in 70-80% of cases of labor and about 70% of cases of perineal tears require suturing. Some degree of perineal tears include:
Grade 1 tear: Limited tear in the vaginal mucosa and perineal skin layer Grade 2 tear: tear to the fascia and perineum muscle Grade 3 tear: tear to the anal sphincter Grade 4 tear: tear to penetrate the rectum mucosa, so a relationship will occur between the vagina and rectum (upper part of the anus) Management of perineal tears varies, grade 1 tears generally heal well without suturing. Rips grade 3 and 4 must be treated with sutures to repair the wound and heal the wound well. Research from the cochrane shows that there is no difference in the outcome between stitching or not stitching (natural healing) in first and second degree perineal tears. However, in practice most of the second degree tears will still be sutured so that bleeding can stop and wound healing results are better (tight) .
Care for perineal wounds is to wash the area with clean water and dry by sticking a towel (not rubbing), taking pain relievers that have been prescribed, consumption of stool softeners, not using underwear that is too tight or too rough that can irritate the wound, avoid sexual intercourse for some time.
Complications of perineal tears include:
Wound infection Deh Licensed fecal incontinence Chronic perineal pain Chronic intercourse fistula (abnormal channel) between the anus and vagina Dehlicated perineal wound management includes:
Re-stitching / re-suturing Only wound care and waiting for the natural healing of the wound without re-stitching (expectant management). There is no RCT study that proves the significant benefits of suturing compared to expectant management for cases of deine licensing of perineal wounds. Generally, doctors consider which day the wound is dehlicated, whether the tissue condition is possible to be re-stitched, the condition of the tear whether it is possible to heal naturally, the presence or absence of infection in the wound that needs to be treated first because if it is sewn also will not occur good wound healing, it is necessary whether or not additional surgery to repair the vagina + perineum, and so forth. Perineal tears require healing time which varies depending on the condition of the tissue, the degree of tear, the presence or absence of wound infection between 3-6 weeks.
Please do further tests directly with your obstetrician to be able to evaluate the condition of your perineal wound and then determine the best treatment to help heal the wound. Thus the explanation from me, hopefully useful.