CESAREAN STITCHES

In cesarean operation, the operation is ended by putting stitches in layers in various tissues such as uterus, fascia, subcutaneous and skin. The stitches thrown for skin closure are both cosmetic and wound infection, opening, etc. It is important to prevent complications from developing. The skin incision that is routinely performed during cesarean section is called the "pfannenstiel incision" applied horizontally in the lower abdomen. Very rarely, in some cases it may be necessary to apply an incision that runs perpendicularly down the navel, this is called the "sub-navel midline incision". In both cases, similar sewing methods are applied for skin incision. Of course, the pfannenstiel incision, which is routinely applied in terms of the patient's cosmetic satisfaction, gives much better results and also causes less pain.
How is the skin sewn in cesarean surgery?
The most common methods of skin stitching are usually:
1- The stitch that is thrown under the skin invisibly from the outside: This is called subcuticular suture and generally self-melting (absorbable) suture materials are used. The stitch is sutured to be continuous, not individually. The reason why it is called cesarean aesthetic stitching is that the stitch is not visible from the outside and most importantly, it leaves a small amount of scar.
2- Individual sewing method thrown on the skin with staples: In this method, the edges of the wound are brought closer to each other with the loops placed individually, just like a stapler. These staples are taken simply and painlessly, usually one week after surgery.
3- Sewing methods that are thrown on the skin with individual threads: Usually such sutures are thrown with spontaneously insoluble sutures, and stitches should be taken one by one approximately 1 week after surgery.
4- Adhesive tape method (strip): Transparent thin tape called strip is attached on the wound and the wound edges are brought to the opposite side. It is a practical method that can be used in wounds with low tension.
Among these, the most frequently used method is the number one method. There are many studies comparing the methods mentioned in numbers 1 and 2, and different results are obtained in them:
In a study, there was no difference between factors such as appearance, pain, and infection.
In another study, opening of the wound and infection were observed more in punching. However, no difference was observed in subjects such as wound image, pain, and patient satisfaction. The subcutaneous suturing technique took longer time. Similarly, in another metaanalysis, wound opening and infection were seen twice as much in stapling. Although the staple method, the stapler method took a shorter time, no difference was observed in terms of pain and cosmetics.
When will the stitches heal?
The formation of the upper epithelial layer of the skin occurs within 24-48 hours. For this reason, the patient is usually allowed to start bathing 2-3 days after surgery. It takes about 1 week for the skin tissue to adhere strongly and to close completely.
How many days after surgery are the stitches removed?
Normally routine subcutaneous sutures are not removed and will melt away and disappear. If suturing with an insoluble suture is taken, it is usually taken 6-7 days after surgery. In some cases, stitching time may vary.
Are stiffness and swelling at the seams and edema normal?
It is normal to have slight stiffness and swelling in the areas close to the suture area, especially due to edema in the first weeks. If there is an excessive swelling, you should consult your doctor. Too large and red-purple swelling can mean hematoma.
Opening the seam:
Opening the skin stitch is a rare occurrence. Many factors such as patient's hygiene measures and sewing method may play a role in this. In case of opening the sutures, it is generally ensured that the dressing is performed and closed automatically in a short time. Rarely, a few stitches may be required again, especially if the clearance is large. If the wound edges do not appear adjacent to the skin incision area and yellow skin is seen between the skin, it can be understood that there is an opening if there is fluid.
Pain, burning, itching and numbness in the seam area:
Mild pain and burning in the first days after cesarean are normal near the seam area. The pain is particularly high at the ends of the skin incision and generally at the right end. Feeling numb at the edges of the skin incision can last for weeks. Occasional mild itching may occur. In case of extreme pain, you should consult your doctor.
Redness, temperature, foul-smelling discharge at the seam:
The increase in temperature and redness in the suture area may be a sign of infection (inflammation), especially if there is a smelling yellow-green discharge. In this case, you should contact your doctor. Having only clear odorless discharge without temperature is usually a non-infectious discharge. If inflammation is detected, the healing process is usually observed with methods such as antibiotics and wound care, dressing, debridement.
Bleeding at the seam:
Slight bleeding is common at the suture on the day of the operation. Since there is a white patch or gauze on the seam area, it is noticeable with redness leaking here. If the bleeding is excessive, it is often stopped easily by printing with the weight put on it. However, after the patient goes home, there should be no bleeding from the stitch area. In case of bleeding or red discharge, you should immediately consult your doctor.
How to make aesthetic stitching in cesarean? Are stitches removed ?:
The stitch, which is called aesthetic stitching or hidden stitch among the people and thrown under the skin invisibly from the outside, is called a sub-cuticle (subcutaneous) stitch. It is also mistakenly called laser stitching among the people. However, this process has nothing to do with laser.
How to make an aesthetic stitch: Usually, self-melting (absorbable) sewing threads are used and melt automatically without the need to remove stitches. However, it can also be applied with stitch threads that do not melt and that should be removed 1 week after surgery. The suture that is passed from one end of the incision to the other end of the incision is discarded under the skin, not visible from the outside. Fine suture materials are used.


Facebook Comments

Subscribe to: Post Comments (Atom)

Popular Posts