Perineal stitches are a common outcome for many individuals following childbirth, often due to natural tears or an episiotomy. This article explains how to assess healing and when to seek medical attention.
Understanding Perineal Healing
Childbirth can cause tears or require an episiotomy in the perineum, the area between the vagina and anus. Stitches are often needed for proper healing. Tears range from first-degree (skin-deep) to fourth-degree (extending to the anal sphincter and rectum), with second-degree tears involving perineal muscles being common.
Perineal stitches are typically dissolvable, absorbing into the body over time. Most skin stitches dissolve within one to three weeks. Full tissue healing usually takes four to six weeks, but more extensive tears may require eight weeks or several months for complete recovery.
Healing involves new tissue growth filling the wound. This tissue matures into a scar that initially appears red but fades over months. While stitches dissolve, underlying tissue repair continuously strengthens the area.
Key Indicators of Healing
As perineal stitches heal, visual signs include reduced redness and swelling. Wound edges should come together without significant gaping, and the area should appear less raw.
Sensory improvements include a gradual decrease in pain and soreness, especially when sitting or walking. Discomfort should diminish daily, leading to improved comfort.
Functional improvements include easier, less painful urination and bowel movements. The ability to sit comfortably and move gently without significant discomfort are positive signs. Gentle pelvic floor exercises, if approved by a healthcare provider, can also support healing.
Recognizing Potential Complications
While most perineal stitches heal without issues, recognize signs of complications. Infection signs include increasing pain, fever, or flu-like symptoms. Other indicators are foul-smelling discharge, pus, spreading redness, increased swelling, or warmth around the stitched area.
Stitches coming undone (dehiscence) can cause increased pain, new bleeding, or pus-like discharge. You might also feel unwell, notice stitch material coming away, or see the wound opening or gaping. Broken sutures or a sensation of pulling or ripping also suggest dehiscence.
A perineal hematoma, a blood collection under the skin, causes intense pain, a firm bulging swelling, or bruising. Other symptoms include feeling like sitting on a ball, difficulty walking, or problems with urination or bowel movements. Excessive bleeding (soaking more than one pad per hour, clots larger than an egg), dizziness, or extreme weakness require immediate attention.
Seeking Medical Guidance
Seek medical guidance if concerns arise about perineal stitch healing. Contact a healthcare provider for persistent or worsening pain that doesn’t improve daily. Report any unusual or foul-smelling discharge, increased redness, swelling, or warmth around the stitches.
Fever or flu-like symptoms, difficulty passing urine or stool, or visual signs of the wound opening (gaping, broken sutures) require medical evaluation. Excessive bleeding (heavy pad soaking, large clots) needs immediate medical attention. Discuss any healing concerns at routine postnatal check-ups, typically around six weeks postpartum.