An episiotomy is a surgical incision made in the perineum, the tissue between the vaginal opening and the anus, during childbirth. This procedure is sometimes performed to enlarge the vaginal opening, aiding the baby’s passage and potentially preventing more extensive tears. Stitches are used to repair the incision after delivery.
Understanding Dissolvable Stitches and Their Timeline
Dissolvable stitches are made from materials the body can naturally absorb. These can be synthetic polymers or natural materials, and the type influences how quickly they dissolve.
The dissolution process occurs through two primary biological mechanisms: hydrolysis and enzymatic degradation. Synthetic stitches dissolve via hydrolysis, a chemical reaction where water molecules break down the material. Natural stitches are absorbed through enzymatic degradation, where the body’s enzymes metabolize the material.
For episiotomy repairs, these stitches typically begin to break down within days and are generally absorbed within 1 to 3 weeks. However, the timeline can vary, with some stitches taking up to 4 to 6 weeks to fully disappear, depending on the material and individual healing rates. Observing small pieces of stitch material on sanitary pads or toilet paper as they come away is normal.
While stitches dissolve, the wound itself needs a longer period for complete healing. The stitches hold the wound edges together during initial healing.
Caring for Your Episiotomy Site
Proper care of the episiotomy site promotes healing and manages comfort as the stitches dissolve and the wound mends. Maintaining good hygiene helps prevent infection and supports the healing process. Gently cleaning the area with warm water after using the bathroom, perhaps with a peri bottle, and then patting it dry is recommended.
Frequent changes of sanitary pads are recommended to keep the area clean and dry. To alleviate discomfort, applying ice packs wrapped in a cloth to the area for 10-20 minutes at a time during the first few days can reduce swelling and pain. Warm sitz baths can also provide temporary relief and promote healing.
Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can effectively manage pain. Sitting on a donut-shaped cushion or squeezing the buttocks together while sitting can reduce direct pressure on the wound. To avoid strain during bowel movements, consuming fiber-rich foods and drinking plenty of fluids can help prevent constipation, and a healthcare provider might recommend stool softeners.
When to Contact Your Doctor
While episiotomy healing often progresses without complications, be aware of signs indicating a problem. Contact a healthcare provider promptly to address any issues quickly.
Signs of a potential infection include increasing pain, redness, or swelling around the episiotomy site. Other indicators are pus-like discharge, a foul odor from the wound, or a fever.
Seek medical advice if stitches appear to be coming apart before the wound has healed. Persistent or worsening severe pain not relieved by medication, excessive bleeding, or worsening difficulty or pain with urination or bowel movements also warrant immediate medical evaluation.