Do perineal sutures need to be removed?

After delivery, the doctor or midwife usually closes the perineal tear with stitches. The stitches will dissolve in 1 to 2 weeks, so they will not need to be removed. You may notice pieces of the stitches on your sanitary pad or on the toilet paper when you go to the washroom.

Does perineal suturing make a difference?

Given the minimal increase in costs associated with suturing, it is recommended that until a long term study is undertaken, women with perineal tears be sutured. This study has provided results in a small group of participants, which show statistically significant differences in the healing between the two groups.

Which repair method is likely to reduce perineal tear?

Episiotomy is a surgical incision performed by the accoucheur to expedite the delivery of the baby or prevent significant tears. This procedure is done with scissors or scalpel and requires repair by suturing (Thacker 1983).

How long does it take for your perineum to heal after childbirth?

If you have stitches due to a torn or cut perineum (see “Perineum soreness,” above), it will take 7-10 days to heal. The stitches will absorb over time. It is important that you keep the stitches from getting infected by gently cleaning them with warm water after each time you use the toilet.

How do you treat an infected perineal stitch?

Most cases of infected stitches can be successfully treated with a topical or oral antibiotic with no long-term effects. If you notice that your stitches have become red, swollen, more painful, or are oozing pus or blood, see your doctor.

How do you fix a torn perineum?

Begin with closure of the rectal mucosa with running suture (2) and repair of lacerated anal sphincter using interrupted suture (4). Deep vaginal tissue (3) and perineal body (5, 6) should be repaired with interrupted suture. Closure of perineal skin is completed using continuous intracutaneous stiches (7).

How do you classify perineal tears?

A 2nd degree tear is a tear to the skin and muscle layers of the perineum. 2nd degree tears heal better when they are repaired with stitches. What are 3rd and 4th degree tears? A 3rd degree tear is a tear through the perineal muscles and into the ring-shaped muscle that surrounds the anus (the anal sphincter).

Can episiotomy reopen years later?

This can be repaired surgically even years later. Despite what some may say, even the best doctors and midwives will encounter 3rd- and 4th-degree tears, as childbirth is a traumatic event to the tissues of the vagina and perineum. Repair of an episiotomy is generally straightforward.

How do you fix perineal lacerations?

The most commonly used suture for the repair of perineal lacerations is braided absorbable suture or chromic. Braided absorbable suture is associated with less pain during recovery and a lower incidence of wound dehiscence. [9] Depending on the severity of the laceration, access to an operating room may be required.

How can I heal my perineum?

Recovery from an episiotomy or perineal tear

1. Keep an ice pack on your perineal area.
2. Try an anesthetic spray.
3. Have regular sitz baths in a tub of warm, shallow water.
4. Take pain medicine.
5. Take stool softeners and drink lots of fluids to help soften stools and ease pain.

Which is the best suture material for perineal repair?

Chromic catgut is still found to be an effective suture material for perineal repair in resource poor countries as the outcome measures are similar to polyglactin 910. Also the continuous suture technique is found to be less costly as less suture material is required without compromising the outcome.

What do you need to know about subcuticular suture?

Performing a subcuticular suture This technique generally follows dermal suturing to complete a layered closure. It is often performed with an absorbable suture, however, non-absorbable material can be used and removed once the wound has reached an adequate strength. The technique can be thought of as a buried continuous suture.

How is local anesthesia used for perineal lacerations?

2-0 polydioxanone sulfate (PDS) suture on CT-1 needle (for external anal sphincter sutures) Local anesthesia can be used for repair of most perineal lacerations. However, general or regional anesthesia may be necessary to achieve adequate muscle relaxation and visualization for surgical repair of severe or complex lacerations.

What happens when you suture the posterior vaginal wall?

Oedema will develop during the first 24-48 hours and sutures which have been tied too tightly will constrict the tissue, causing pain and compromising the repair. The posterior vaginal wall is now closed using a continuous locking stitch, which ensures good haemostasis.