Following childbirth, many individuals experience a perineal tear or receive an episiotomy, requiring stitches to repair the tissue between the vagina and the anus. This repair is a common procedure designed to promote anatomical healing. While the body heals well, any surgical site risks complications, including infection, which requires careful monitoring. Understanding the difference between expected discomfort and signs of infection is important for a smooth recovery.
Understanding Normal Perineal Healing
Recovery from a perineal repair includes an initial period of soreness. The skin portion of the wound typically begins to heal within 7 to 10 days, though full tissue healing takes four to six weeks. During this time, it is normal to experience aching, tenderness, and mild pain, especially when sitting or changing position. The dissolvable stitches will naturally soften and fall out within a few weeks. Pain should consistently lessen each day, and small amounts of clear or light pink discharge, separate from the normal postpartum bleeding (lochia), may be present.
Key Indicators of an Infected Stitch
An infection presents with specific, abnormal symptoms that deviate from the expected healing pattern.
Local Symptoms
One common sign is pain that does not improve or significantly worsens after the first few days postpartum. This pain may present as a persistent, throbbing sensation unrelated to movement, signaling that the healing process has been disrupted by a pathogen. The wound’s appearance will also change dramatically. You may observe spreading redness that extends beyond the immediate stitch line, accompanied by excessive, localized swelling or heat around the area. This spreading redness is often an indicator of cellulitis, a deeper tissue infection.
Discharge and Odor
Discharge from the wound is another identifier of infection. A foul odor that is distinctly malodorous is a strong indicator. Furthermore, the presence of thick, opaque, yellow, or greenish pus (purulent discharge) draining from the stitch line is a clear sign that a bacterial infection is established.
Systemic Symptoms
Systemic symptoms indicate the infection is potentially spreading beyond the local site. These include a persistent high fever or recurring chills, which require immediate medical attention. A general feeling of being unwell, often described as malaise, can also accompany a localized infection that is becoming systemic.
Preventing Infection and Seeking Treatment
Proactive hygiene measures are the most effective way to prevent a perineal stitch infection.
Prevention
Maintaining cleanliness is paramount. Use a peri bottle filled with warm water to gently rinse the area after every trip to the toilet, both after urination and a bowel movement. This action helps to wash away bacteria without the need for abrasive wiping, which can irritate the wound.
Strict hygiene practices include:
- Washing hands with soap and water before and after any wound care or pad change.
- Changing sanitary pads frequently, ideally every two to four hours, to ensure the wound is not sitting in a moist environment, which encourages bacterial growth.
- Gently patting the area dry with a clean cloth or allowing it to air dry after cleaning.
Seeking Treatment
If you identify key indicators of infection, such as fever, worsening pain, or a foul-smelling discharge, contact a healthcare provider immediately. A medical professional will examine the wound and may take a swab to identify the specific type of bacteria causing the issue. The standard medical intervention involves prescribing a course of oral antibiotics to clear the infection. In rare instances where the infection is severe or causing systemic illness, admission to a hospital for intravenous antibiotics may be necessary. If an infection is present, the wound will typically not be re-stitched immediately, as closing an infected site can trap the bacteria and worsen the condition.