how to repair episiotomy

An episiotomy repair is critical. It is imperative that your obstetrician can successfully repair the open wound. Repair techniques include buried mattress suture, lock suture, purse string suture, interrupted suture, and continuous suture. Two of the most sought out stitching techniques is the continuous suture and the lock suture method.

Full Answer

What is an episiotomy and how is it repaired?

Episiotomy is a procedure that involves making an incision in the area between the vaginal opening and the anus, and it is done to enlarge the vaginal opening for childbirth. In the past, the practice was done routinely for all types of childbirth to avoid extensive vaginal tears and to hasten healing of the surgical tear.

What do you need to know about episiotomy repair?

• Sometimes the incision of an episiotomy is more extensive than a natural tear might have been
• As with perineal tears, infection is also possible with an episiotomy
• An episiotomy can cause pain during sex for some women in the months after childbirth

More items...

Why you might tear or need an episiotomy?

You may also need an episiotomy if there is a risk of significant vaginal tearing, for example your baby may be large, in an difficult position or requires the use of forceps for delivery. The advantage of an episiotomy over a natural tear in this instance is to prevent severe tears that may affect the anal muscle.

What should I do after an episiotomy?

After an episiotomy, you may have pain at the incision site. An ice pack may help reduce swelling and pain. Warm or cold shallow baths (sitz baths) may ease soreness and speed healing. Medicated creams or local numbing sprays may also be helpful.

Can an old episiotomy be repaired?

You can have a revision episiotomy even years after your original procedure. It's never too late to regain the quality of life you might have thought you lost forever.

What is the fastest way to heal an episiotomy wound?

Exposing the stitches to fresh air can help the healing process. Taking off your underwear and lying on a towel on your bed for around 10 minutes once or twice a day may help. It's unusual for pain after an episiotomy to last longer than 2 to 3 weeks.

Can episiotomy stitches reopen?

What is it? After childbirth, you may have had stitches to repair any perineal tears, or an episiotomy. It is rare for the stitches to simply to come undone. However, occasionally an infection or pressure on the stitches from bleeding underneath can cause the stitches to breakdown, leaving an open or gaping wound.

Does episiotomy heal completely?

Most episiotomies heal in 3 weeks. But it may take longer. This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace.

Which ointment is best for episiotomy wound?

Silybum marianum ointment ointment accelerates episiotomy wound healing rate due to its healing properties and decreases pain severity.

What happens if episiotomy doesn't heal?

See your GP, midwife or health visitor as soon as you can. Occasionally, the wound doesn't heal well and may come apart . You may need an operation to fix this. Most women who have an episiotomy find sex painful in the first few months, but this does get better over time .

Can episiotomy stitches open years later?

If you had an episiotomy that healed poorly and is causing discomfort or pain, a revision episiotomy can be done even years later to repair the issue. A revision episiotomy can remove excess tissue (granulation tissue) and knots that may have developed from the previous episiotomy.

Can episiotomy cause problems years later?

There is often less blood loss with a midline episiotomy as well. The main disadvantage of a midline episiotomy is the increased risk for tears that extend into or through the anal muscles. This type of injury can result in long-term problems, including fecal incontinence, or the inability to control bowl movements.

What should I do if stitches break open?

If you incision breaks open, call your doctor. Your doctor may decide not to close it again with stitches. If that happens, your doctor will show you how to care for your incision a different way. This will likely involve the use of bandages to absorb the drainage that comes from the incision.

Does episiotomy leave a scar?

With an episiotomy, due to the depth and stitches, you're very likely to have at least some scarring. Some will experience pretty deep scar tissue as well. In the absence of nerve and muscle damage, many don't find the scar tissue to bothersome.

How do I know if my episiotomy stitches are healed?

Episiotomy stitches usually start to dissolve within a few days, and are gone after a week or two. You may notice pieces of the stitches (appearing as little black specks left behind on the toilet paper) when you wipe yourself.

Can episiotomy scars hurt years later?

Tissue damage may be internal, so scar tissue can form postsurgery or as a result of disease. In the early stages, scar tissue isn't always painful. This is because nerves in the area may have been destroyed along with healthy body tissues. But over time, scar tissue may become painful as nerve endings regenerate.

How long does it take for an episiotomy stitch to heal?

It tends to take between 2 and 4 weeks for stitches between the vagina and back passage (perineum) to heal, but everyone is different and you may find it takes longer.

How can I make my wound heal faster after birth?

Make use of ice packs. Putting ice on your stitches can help heal your wound faster by easing inflammation. You can get ice packs that you can wear just like pads. These ice packs should be worn for about 10 to 20 minutes to ease pain from stitches after birth.

How do you make a cut on your vagina heal faster?

How to treat superficial cutsWash the area with warm water once or twice per day.Refrain from using harsh or perfumed soaps, as this can affect the delicate pH balance of your vagina.Make sure the area is dry before you get dressed again.Wear cotton underwear and loose bottoms until it's healed.

How can stitches heal faster?

If you did not get instructions, follow this general advice: After the first 24 to 48 hours, wash around the cut with clean water 2 times a day. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the cut with a thin layer of petroleum jelly, such as Vaseline, and a non-stick bandage.

What do you need to know about episiotomy repair?

Everything You Need to Know About Episiotomy Repair. Giving birth is a without a doubt one of the most beautiful aspects of life itself. However, while you’re thinking of your birth plan, it’s important to consider the less attractive aspects – like the possibility of an episiotomy repair! It would be ideal to have an easy recovery ...

How to avoid an episiotomy?

Avoiding Episiotomies. Fortunately, there are methods that you can do to reduce your risk of an episiotomy. Perineal massage: A perineal massage helps with the elasticity of the perineum (the skin between your vulva and anus). It will increasingly raise your chances of a tear free vaginal birth.

What is the difference between first degree and second degree episiotomy?

The tear is either classified as first, second, third or fourth-degree tears. A first-degree tear is a tear in the vaginal and perineal skin only. The second degree is a tear in the vaginal wall and underlying perineal muscles.

How long does it take for a laceration to heal?

A third-degree tear involves the anal sphincter. The fourth degree is a laceration to the perineum and the rectum. Healing takes about 4-6 weeks depending on the size of the incision.

What are the two techniques used to repair a mattress?

Repair techniques include buried mattress suture, lock suture, purse string suture, interrupted suture, and continuous suture. Two of the most sought out stitching techniques is the continuous suture and the lock suture method.

Can a stitch hurt the rectum?

Even with a perfect stitch, the wound will still be at risk to heal properly. Furthermore, a laceration in the perineum can cause further tear down to the rectum. Also, the wound may result in long term effects such a painful sexual intercourse and rectovaginal fistula (stool or gas passing through the vagina).

Is episiotomy worse than natural tearing?

Fast forward to 2005, the Journal of the American Medical Association released new evidence that the outcome of an episiotomy is worse than natural tearing.

Abstract

Episiotomies are used to enlarge the birth canal. The author describes in detail the anatomy, indications, repair and after-care. He includes diagrams to illustrate the method of repair.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (502K), or click on a page image below to browse page by page.

What is the procedure for an episiotomy?

Generally, an episiotomy follows this process: You will lie on a labor bed, with your feet and legs supported for the birth. If you have not been given any anesthesia, your provider will inject a local anesthetic into the perineal skin and muscle. This will numb the tissues before the incision is made.

How to help pain after episiotomy?

An ice pack may help reduce swelling and pain. Warm or cold shallow baths (sitz baths) may ease soreness and speed healing. Medicated creams or local numbing sprays may also be helpful. You may take a pain reliever as recommended by your doctor.

Why is it important to have an episiotomy?

Sometimes the vaginal opening does not stretch enough for the baby's head. In this case, an episiotomy aids your healthcare provider in delivering your baby. It's important to make a surgical incision rather than letting the tissue tear.

What to do if you don't have an epidural?

If you don't have an epidural, your provider may inject a numbing medicine into the perineum.

How to care for a bowel infection after urination?

Be sure to take only recommended medicines. Keep the incision clean and dry using the method your healthcare provider recommends. This is important after urination and bowel movements. If bowel movements are painful, stool softeners recommended by your healthcare provider may be helpful.

What is the procedure to get a baby's head out of the vagina?

An episiotomy is a cut (incision) through the area between your vaginal opening and your anus. This area is called the perineum. This procedure is done to make your vaginal opening larger for childbirth. Normally, once the baby's head is seen, your healthcare provider will ease your baby's head and chin out of your vagina.

Can an episiotomy be done for fetal distress?

This can be harder to repair. Your provider may advise an episiotomy in these situations: The baby does not have enough oxygen ( fetal distress) Complicated birth, such as when the baby is positioned bottom or feet first (breech) or when the baby's shoulders are trapped (shoulder dystocia) Long pushing stage of labor.

Why do you need an episiotomy?

You may need an episiotomy to prevent damage to your vaginal area. Damage can occur if your unborn baby is larger than your vagina can stretch. You may need an episiotomy if your caregiver uses forceps or a vacuum extractor during labor. These tools help pull your baby out of your birth canal gently and quickly.

What is the procedure called when a woman's vagina opens?

An episiotomy is an incision (cut) made in the area between a woman's vagina (birth canal) and rectum. Pregnant women have this procedure done during the second stage of labor to make the vaginal opening larger. During the second stage of labor, the uterus (womb) contracts (squeezes) to push your baby out. The second stage of labor ends ...

How to reduce pain from sitz bath?

A cold sitz bath may decrease your pain right away. To make a cold-water sitz bath, sit in slightly warm water and add ice cubes to the water. Stay in the sitz bath for 20-30 minutes, or as long as your caregiver suggests. Ask your caregiver for more information about sitz baths and other ways to decrease your pain.

What to do if your medicine is not working?

Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine. Nonsteroidal anti-inflammatory medicine: This family of medicine is also called NSAIDs.

Does a wound stop bleeding?

Your wound will not stop bleeding. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Can you use a tampon when you have pain?

Tampon use: Your caregiver may say it is okay to use tampons when your pain is gone. Change tampons often and use them only during the daytime. This may prevent you from getting a serious infection called toxic shock syndrome. Ask your caregiver for more information about tampon use.