Caring for Your Episiotomy Stitches

Tips for Keeping the Wound Clean and Free of Infection

Parents with newborn at hospital
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An episiotomy is a surgical incision in the area between the vagina and anus made just before delivery to enlarge the vaginal opening. After the baby is delivered, stitches will be used to close the wound. Caring for these stitches is important as it helps minimize the risk of pain and infection during the healing process.

About Episiotomy Stitches

After an episiotomy is performed, the doctor or midwife will repair the perineum (the area between the anus and vulva) by stitching the wound closed.

Today, dissolvable sutures (also known as absorbable sutures) are almost always used for an episiotomy. It generally takes a week or two for the stitches to fully break down. As such, you don't have to return to the hospital to have them removed, and there are rarely any complications associated with their use.

The stitches are typically black but may come in other colors, as well. They will usually begin to dissolve within a few days, which you will notice when you wipe yourself. When you do, there will be little black specks left behind. This is perfectly normal.

How to Care for Your Episiotomy Stitches

Once you return home from the hospital, you will likely feel tender around the perineum. There may be a persistent pain or throbbing, or you may feel an occasional tug or jab. You can often reduce this discomfort by using an ice pack for the first day or so, especially if the wound is still swollen and red.

While there are no special care instructions per se, you will definitely want to keep your perineum clean. You can do this using a squirt bottle filled with warm every time you use the bathroom. Simply pat the area dry rather than wiping to prevent tugging the stitches.

Other helpful tips include:

  • Use baby wipes instead than toilet paper, if possible.
  • Always wipe front to back.
  • Use an antibacterial sanitizer to prevent infecting the wound with your hand.
  • Change your pad every two to four hours.
  • Buy a shallow mini-tub called a sitz bath which fits over the toilet seat and allows you to run warm water over the stitches for cleansing and pain relief.
  • If you have problems drying the wound, you can use a blow dryer set on low.
  • Over-the-counter pain relievers like ibuprofen can help alleviate discomfort.
  • Cooling medicated pads marketed for hemorrhoid use may also provide relief. Choose one that is hypoallergenic, pH balanced, and perfume-free.
  • Numbing sprays specifically made for new mothers can also be found at most drugstores. Lidocaine gels may also help.
  • Tampons should be avoided for the first six weeks.

You will typically have your stitches checked at your six-week postpartum visit. At that time, the doctor or nurse will be able to tell you when you can resume sexual relations and offer tips on how to deal with incontinence or any other problem you may be experiencing.

You may also be advised about kegel exercises to help restore muscle tone around the perineum.

When to Seek Urgent Care

As with all surgical procedures, infection is possible following an episiotomy.

Do not hesitate to call your doctor if you experience any of the following symptoms:

  • Severe pain at the incision site
  • Redness and swelling around the stitches
  • Visible pus in or around the wound
  • Fever of 100o F or more

If your doctor is not available, go to the nearest emergency room without delay.

Sources

  • Kettle, C.; Dowswell, T.; and Ismail, K. "Absorbable suture materials for primary repair of episiotomy and second-degree tears ." Cochrane Database of Systematic Reviews. 2010: CD000006.
  • Kettle, C.; Dowswell, T.; and Ismail, K. "Continuous and interrupted suturing techniques for repair of episiotomy or second-degree tears." Cochrane Database of Systematic Reviews. 2012;11:cd000947

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