Care of postoperative suture after abdominal surgery. Postoperative suture care at home

Hello PAVEL.

The healing process of any surgical suture entirely depends on the level of resistance of the skin and the entire organism as a whole. In addition, microbial lysis interferes with healing, i.e. infection pathogenic microorganisms and subsequent suppuration. That is why it is important to know how to properly and effectively care for a stitch at home after a laceration caused by a fall.

Seam treatment at home at the initial stage

Today, despite the huge number of antiseptics and medications that help activate the healing and regeneration processes of the skin, ordinary iodine and potassium permanganate remain the most effective. As they say, “cheap and cheerful”!

You should know that treating the seam once a day is not enough. This must be done at least 2-3 times. Moreover, at the emergency room you should have been warned that you can wet the place where the suture was placed on the wound no earlier than a week after the provision of medical measures. And while taking a shower, and while dressing, and at any other time, you must not touch the seam or have any mechanical impact on it. This can damage the healing scar on the skin and significantly delay the wound healing process.

It is necessary to treat the wound until the sutures have healed completely. At first, it is necessary to apply a sterile bandage to the stitches. When the wound begins to dry out, the bandage can be removed to allow access more oxygen to the wound. It is recommended to remove the sterile dressing only if the suture is dry and there is no pus, blood or other liquid oozing from the wound. By the way, the release of fluid from the suture is a very common complication during healing. lacerations, which were stitched. It is not recommended to treat such seams at home; this should be done by a trained specialist. The fact is that the release of fluid from a wound is a sign of infection, so to avoid the development of further complications it is necessary to seek qualified help.

Treatment of the seam consists of carefully blotting the seam with a gauze cloth (it is strictly not recommended to use cotton wool, since its particles remaining on the wound can provoke the development of an inflammatory process), generously soaked in hydrogen peroxide, and then cauterize it with brilliant green. This is the simplest and most affordable option for wound care. In addition to brilliant green, you can treat the wound with alcohol or another antiseptic. Castellani liquid or fucorcin are best suited for this. Also stock up on sea buckthorn ointment, milk thistle oil or Levomekol. The principle of action of these drugs is the same. They promote faster healing of the wound, and the scars look neater and are subsequently less noticeable. Later, when the wound heals, it will be possible to treat it with Panthenol. It's also quite effective remedy for treating sutures of all types of wounds. If the wound heals well and without complications, you can add physiotherapeutic procedures, which involve the use of various absorbable solutions, as an additional therapy.

Scar treatment after suture removal

After the doctor removes the stitches (approximately this happens in the third month), the wound site can be treated with Mederma or Contractubes ointments. These are very effective medicines, long-term and regular use of which allows you to almost completely get rid of scar formations on the skin that appear as a result of tissue damage during injury and subsequent suturing. If the aesthetic aspect is of fundamental importance to you, be sure to consult with the doctor who will remove the stitches about the use of these ointments.

Best regards, Natalya.

When all the fears associated with the operation are behind you, you should think about... Treatment of sutures should begin immediately after surgery. When a person is still in the hospital, the medical staff monitors the condition of the postoperative suture. But after discharge home, you will have to take care of scar care yourself.

Will there be a scar? Of course it will remain. But whether it will be thin and almost invisible or thick and convex largely depends on how you care for it. If the suture is not treated, complications are possible.

First postoperative days

After the operation, you must carefully observe the suture; there should be no discharge from it. In the first days after surgery, the seam must be lubricated with brilliant green, iodine or vodka. A bandage is applied to the wound before the stitches are removed.

Fact! In places with an active blood supply and a large concentration of blood vessels, for example on the face, healing of the postoperative suture occurs faster.

Due to microorganisms entering the seam, the wound may fester. Infection also occurs from hematomas, because blood is a good breeding ground for bacteria. At the first signs of suppuration, the suture should be lubricated with hydrogen peroxide or chlorhexidine solution, this will reduce the risk of further infection.

Advice! To avoid serious consequences, it is better to consult a doctor.

Medicines will relieve the consequences

After discharge from the hospital, the doctor must give clear instructions on what to do with the stitches and provide a list of recommended medications. But if for some reason this did not happen, then do not worry. In pharmacies there is a huge selection of suture care that will help the skin heal without complications, you just need to make the right choice.

Contractubex ointment

Before using the ointment, you should consult your doctor. The fact is that the suture after surgery can begin to be lubricated with ointment only 2 weeks after the operation. But if there is a tendency to form keloid scars, then Contractubex should be started as early as possible, because within 2 weeks the keloid will be fully formed.

The ointment contains:

allantoin;
onion extract;
heparin sodium.

Thanks to this composition, Contractubex ointment improves blood circulation, which promotes rapid healing. It has anti-inflammatory, fibrinolytic and antiproliferative effects. In order to minimize the formation of scars after wound healing, the ointment must be applied daily for at least 3 months. Excellent for treating and.

Solcoseryl gel (ointment)

Available in the form of a gel or ointment. The gel contains deproteinized dialysate from the blood of dairy calves - this is an active substance that enhances blood circulation in damaged tissues.

The active substance of the gel stimulates cells to regenerate and repair, due to which the wound healing process occurs faster and tissue scarring occurs without pathologies.

Important! The ointment can only be applied to dry wounds. But the gel, on the contrary, has proven itself well in working with weeping wounds.

Solcoseryl gel is applied to freshly disinfected seams 2 times a day. Apply until a crust forms and the wound dries.

Solcoseryl ointment can be applied using a bandage, since, unlike the gel, the ointment is quite oily. Apply to dry seams at least 2 times a day until scar tissue forms.

There are no serious contraindications for use. In rare cases, slight redness of the skin may occur. In this case, it is better to stop using the drug or reduce the number of procedures.

Acerbine spray

Available in the form of a liquid solution. A convenient sprayer allows you to evenly apply the solution to the wound. The composition includes malic, salicylic and benzoic acids. It has a noticeable antiseptic and analgesic effect. Prevents the formation of fluid in the wound. Malic acid removes excess carbon dioxide in the wound, has an excellent drying effect and the wound quickly epithelializes.

Acerbine spray is applied 1-2 times a day. When a crust forms, the number of procedures can be reduced to once a day. Has no contraindications, but can sometimes appear allergic reactions. A slight burning sensation at the time of application quickly passes and is a normal reaction of the wound to the drug.

Traditional medicine to help

Of course, it is better to use pharmacological drugs to care for postoperative wounds. But if it is not possible to purchase drugs at the pharmacy, you can resort to simple ones.

Important! When using folk remedies, strictly observe sterility so that the wound does not fester.

Traditional recipes do not have a serious therapeutic effect, but they certainly make the scar less noticeable. Making wound treatment products at home is very easy and does not take much time. Here are some simple recipes:

Aloe juice has effective wound healing properties and is also an excellent antiseptic. Aloe juice should be smeared on a fresh seam regularly, this will help scar tissue and prevent inflammation of the seams. Effectively treats fresh wounds on the face.
Juice heals wounds well onions. To do this, you need to chop the onion until a paste forms, wrap it in gauze and apply to the wound 1-2 times a day. Onion juice kills all kinds of microbes, the stitches will not fester, the wound will heal quickly, and the scar will be less noticeable.
A mixture of garlic and honey will help kill harmful bacteria, tissue epithelization will occur much faster. In addition, honey improves blood supply to tissues, which helps avoid severe scarring. The mixture must be smeared on the seam 1-2 times a day, after the honey is absorbed, the residue must be carefully removed with a sterile damp cloth.

Procedures using medical supplies and funds home care must be done during the process of skin scarring, then they will be effective. If treated diligently and systematically, it will not cause complications and will be less noticeable in the future.

To eliminate an already formed scar, it will be possible to use more serious methods, such as mesotherapy. But this is only a year after the formation of the scar. With proper care of the wound after the stitches are removed, there will be no need to resort to radical methods of scar removal.

The patient is not always given recommendations on how to treat the postoperative suture for better healing. Modern means presented in a wide variety, the main thing is not to make a mistake with the choice. Products that are identical in purpose may not be suitable in different situations. The patient should know in which case to use one or another method of therapy.

Why is it important to properly handle the suture after surgery?

The attending doctor should provide information about further manipulations, but, unfortunately, this does not always happen in modern clinics and hospitals. The patient returns home after long-term therapy and does not know how to properly treat the postoperative suture for better healing. Correct tactics are important for quick and speedy healing. Surgeons focus on home treatment of sutures; they become common cause complications.

If redness, swelling forms at the site of the postoperative suture, blood, pus, bile, etc. are released, you should immediately seek help from a doctor, this indicates a complication. It is necessary to carefully monitor the condition of the wound after surgery.

Proper wound treatment is important for the following reasons:

to avoid serious complications that could lead to repeat surgery;
to maintain the sterility of the wound to prevent suppuration and infection;
for a speedy recovery;
to prevent pain;
to avoid the inflammatory process.

If a person correctly performs the manipulations to treat the seam, recovery occurs on average after 2 weeks. It all depends on the type of operation, severity, and type of suture.

How does rapid healing occur?

Wound healing occurs differently in each patient depending on the type of suture and the severity of the wound surgical intervention. You should never leave a wound untreated. Treatment is needed to ensure a quick recovery and the stitch to heal without complications.

Ointments and other medications with antiseptic, anti-inflammatory, and regenerating effects help to quickly get rid of the unpleasant consequences after skin surgery. They are necessary in order to:

rapid tissue regeneration occurred (recovery, wound closure);
no inflammatory process occurred due to antibacterial and antiseptic properties;
improve the quality of newly formed tissue;
reduce internal intoxication.

Healing occurs in several stages, they are clearly visible during processing manipulations. Firstly, the wound is disinfected, which promotes healing; bacteria cannot prevent the wound from healing. Secondly, the ointments and creams used help speed up regeneration, that is, help the skin recover and improve the quality of the new tissue being formed.

Taken together, all actions lead to the fact that the seam heals soon.

Treatment - how to speed up the healing of postoperative sutures with ointments and other means

At the initial stage, each operated patient should understand the stages of suture treatment in order to understand when it is necessary to perform the necessary actions (apply ointment, clean the wound, etc.).

Seam processing at home is performed as follows:

carefully remove the bandage from the suture, applied in a medical institution (if the bandage has dried, you should slightly soak it with hydrogen peroxide);
analyze the condition of the postoperative wound to exclude the appearance of pus, bile, swelling, etc. (if these symptoms occur, you should contact a medical facility);
if there is a small amount of blood, it should be stopped before manipulation with a bandage;
first, you should not spare the liquid, it should moisten the wound generously;
you need to wait until the product stops contacting the seam (stops hissing), then carefully wipe it off with a sterile bandage;
then, using a cotton swab, the wound along the edges is treated with brilliant green;
ointments should be applied only after the stitch begins to heal a little, approximately 3-5 days after discharge.

You can speed up the healing of postoperative sutures with the help of special ointments. They are aimed at accelerating tissue regeneration and providing an anti-inflammatory effect. Popular ointments include:

Iodine is an inexpensive and easy-to-use remedy; you can call it an analogue of brilliant green. But it is not recommended to use it frequently, every day; it is worth taking a alternate course with ointments, since the liquid can significantly dry out the skin, which will cause slow regeneration.
Dimexide is a solution widely used in postoperative practice. With the help of the drug you can not only treat the wound, but also make lotions and compresses.
Miramistin is suitable as an antiseptic. It can be used instead of hydrogen peroxide. It is believed that due to its antimicrobial properties, the drug is more effective in therapy. Apply throughout treatment to cleanse the wound.

Possible complications - what to do if the seam becomes inflamed?

complication of postoperative suture in the photo

To begin with, the patient should understand what inflammation is, how it manifests itself and is recognized, in what situation home therapy should be carried out, when to seek treatment medical care. The following symptoms may indicate the presence of an inflammatory process in a postoperative suture:

there is redness and swelling in the wound area;
the pain syndrome becomes stronger every day;
During palpation, a compaction is felt; as a rule, it does not have sharp boundaries;
on days 4-6, fever, chills, and symptoms of intoxication appear;
the emergence of a specific substrate from the wound, suppuration.

The causes of such complications could be the following factors:

penetration of infection into the wound;
improper care or lack thereof postoperative suture;
incorrectly installed or inadequate drainage installed after surgery;
making a surgical error after the operation.

When the first signs of inflammation appear, it is worth carrying out hygienic treatment of the wound every day with hydrogen peroxide, iodine, and brilliant green. Repeated manipulations may be required depending on the condition of the lesion. When there is no pus, redness and swelling are observed, a one-time treatment can be used. In other cases, from 2 to 4 times a day. After treatment, it is recommended to apply a sterile bandage with ointment, which can be used during the inflammatory process.

There are typical instructions suggesting norms and rules of patient behavior described for a speedy recovery of a postoperative wound. They should be followed by every patient at home. They consist in the following points described in the table below.

Type of load	Rules for caring for postoperative sutures
General recommendations	· eat properly, follow the diet prescribed by the doctor;
	· Use only water and baby soap to wash the wound;
	· maintain hygiene of the wounded area, rinse and clean every day;
	· do not use ointments, creams, gels, or rubs without consulting a specialist.
Shower	You should only take a shower when the wound begins to heal, becomes dry and gradually heals. The duration of the procedure should not exceed 10 minutes. The water in the bath or shower should not be too hot or cold.
Physical activity	In the first 2-3 months you should adhere to the following recommendations:
	· do not stand in one place for more than 15 minutes, do homework only of a mild nature is possible;
	Increase the load gradually;
	· take daily walks fresh air;
	· try not to load the area where the seam is located;
	· should be included in therapy nap, if there are minor loads;
	· Perform exercises only with your own weight, avoid lifting weights;
	· Only walking is considered acceptable.
Sex	Doctors recommend waiting until complete recovery before starting sexual activity. You should not experiment and take risks when intimacy brings shortness of breath, excessive sweating, and fatigue. This indicates the need to temporarily abstain from sex.
Sex	After recovery, you should gradually pick up the pace and rhythm in sexual relationships.
Trip abroad	Travel abroad can be carried out after agreement with the attending physician.
Diet	After surgery it is recommended:
	· exclude unhealthy foods (smoked, overly salted, fried, canned);
	· plant foods should predominate in the diet;
	· take additional vitamins;
	· include bran in the menu;
	· meat and fish – low-fat varieties.
Emotions	All are contraindicated negative emotions. They will adversely affect the condition nervous system which will lead to long-term recovery.

All recommendations are intended for public use. It must be borne in mind that any wound has its own characteristics, which should be discussed with the attending physician. Proper therapy will help you get rid of it quickly unpleasant symptoms physical and moral.

Surgical sutures must be treated daily, but not earlier than one day after surgery. In a medical facility this procedure carried out by a qualified medical professional. But it is not always possible to come to the clinic for dressing changes. You need to know how the suture is treated after surgery. After all, at home you have to do the treatment of stitches and dressings yourself. The procedure should be carried out at approximately the same time. If the location of the seam does not allow you to treat it yourself, it is recommended to seek help from an adult living nearby or nearby.

Materials for processing sutures after surgery

Sutures can be located on various parts of the body, including mucous membranes. How to treat the suture after surgery in a particular case, it is recommended to consult your doctor. For care you will need sterile bandages and cotton wool. You can also use ear sticks. If you don’t have it at hand, you can iron a regular non-sterile bandage on both sides. A sterile bandage is necessary for applying a protective bandage. The bandage only protects the seam from infection and contamination. It is not always rational to use it, since a bandaged seam heals much more slowly. It is recommended to check with nurse whether the wound needs to be protected with a bandage or not. To disinfect the seam, you will need hydrogen peroxide and you can replace it with fucorcin, but remember that with long-term use of fucorcin, its traces are difficult to remove from the skin. At the same time, it dries faster than brilliant green. For a wet seam, this is a compelling argument.

Treatment of sutures after surgery

The seams must be processed at least twice a day. What is processed is already known. To do this, remove the sterile bandage from the wound. If it sticks to the seam, you need to thoroughly moisten the bandage with hydrogen peroxide and wait a little. Then, with a sharp movement of your hand, remove it. Using a cotton swab, disk or cotton swab, gently rinse the seam with hydrogen peroxide. Blot excess solution with a swab. Then apply brilliant green or fucorcin. If necessary, apply a new sterile dressing. Do not apply cotton swabs to the treated seam under the bandage. They dry to the wound and, during subsequent treatment, undermine the resulting crust, thereby preventing healing.

Healing of sutures after surgery

Healing of sutures usually lasts approximately 10-15 days, depending on the specifics of the suture and proper care behind him. Treatment must be carried out until complete healing. Periodically, you need to show the suture to your doctor to monitor the healing process. If it is inflamed, the doctor will tell you how to treat the suture after surgery in a particular case. You cannot treat purulent sutures yourself. It should be remembered that the treatment of sutures on the mucous membranes and face has its own specifics. Such processing should only be carried out by a medical professional in a clinic or hospital setting. You can shower or bathe carefully without using a washcloth only 7-12 days after the suture is applied or as recommended by your doctor. It is not advisable to use bathing gels and scrubs while bathing; it is better to use baby soap. The seams should not be wiped with a towel; it is recommended to blot them with a swab. After hygiene procedures, the seams are processed as usual.

Most of the operations performed at the Northwestern Center for Endocrinology and Endocrine Surgery are performed on the organs of the neck - the thyroid gland and parathyroid glands. In this type of operation, the skin suture is located in a place that is clearly visible, so the requirements for the cosmetic result of the operation are maximum. We use technologies that allow us to reduce the size of the suture (video-assisted operations) or move the suture to an inconspicuous place (endoscopic operations from the axillary approach), and at the same time we use proven and effective methods improving the quality of the postoperative scar. The center's surgeons believe that the cosmetic result of the operation is as important as the clinical result.

Over the years of our work, we have tested many different products aimed at improving cosmetic results. Experiments on animals were also used. Physiotherapeutic procedures were prescribed, gels, creams, plates, bandages and patches were used. The results were carefully evaluated, ineffective means were discarded (there were many of them), and eventually we came to the methods described below, which have become standard for us, since they have proven their real effectiveness.

Ethicon Dermabond Skin Adhesive

During the operation at the Northwestern Center for Endocrinology and Endocrine Surgery, a cosmetic suture is applied to the skin with an absorbable thread, after which the surface of the suture is covered with Ethicon Dermabond skin glue (USA). After drying, the glue forms a transparent, durable film on the surface of the seam, which protects the seam from moisture and air access, ensuring healing under sterile conditions.

The use of glue provides patients with a number of important advantages:
- the surface of the suture is clearly visible to both the patient and the operating surgeon, which allows you to quickly assess the condition of the operation area;
- no dressings required;
- no need to “remove” the seam, i.e. there is no need to pull the thread used to stitch it out of the skin;
- the patient can take water procedures immediately after surgery (usually we recommend starting showering the next day after surgery).

The glue remains on the surface of the skin for 14-20 days, after which it comes off on its own. Already 2 weeks after the operation, the glue can be removed independently - this does not cause any pain and is done very quickly.

Specialists at the Endocrine Surgery Center have been using Ethicon Dermabond adhesive for more than 10 years. Skin glue has proven itself to be excellent - its use allows you to raise the comfort of the operation to new heights.

The use of skin adhesive is standard at the Northwestern Center for Endocrinology and Endocrine Surgery. The adhesive is used for all patients and does not need to be purchased separately.

Silicone patch "Mepiform"

The second important “secret” that allows you to ensure the optimal cosmetic result of the operation is a silicone patch, specially designed to prevent the development of rough and unsightly scars.

The Mepiform patch was developed and produced by the Swedish company Mölnlycke Health Care - a world leader in the development of modern high-tech dressings.

The patch protects the postoperative suture from friction and damage, moisturizes the skin surface and provides optimal conditions for healing. When using a silicone patch, the skin seam is much thinner and less noticeable. The effectiveness of using the patch has been proven in a number of clinical trials (Maján J.I et al. Evaluation of a self-adherent soft silicone dressing for the treatment of hypertrophic postoperative scars. Jo WC, Vol15, No 5 (2006), p.193-6, etc.).

Mepiform is easy to use, fixed to the skin on its own using a layer of soft silicone (Safetac technology). Since the patch is flesh-colored, it is hardly noticeable on the skin. It is easy to use and does not interfere with daily activities.

The effectiveness of the Mepiform patch has been proven by the experience of use in thousands of patients at the North-Western Center for Endocrinology and Endocrine Surgery. Currently, the recommendation to use this patch is provided to all patients discharged from the center.

How to use the Mepiform patch

The most economical is to use 10x18 cm plaster sheets. In most cases, for full course 4 patches are enough (only when performing lateral cervical lymph node dissection, when the length of the postoperative suture exceeds 10 cm, the need for a patch can be up to 6-7 patches).

You should start using the patch after complete removal skin glue. A rectangular section is cut out from the patch plate with scissors, the length of which is 1 cm longer than the length of the skin suture, and the width is about 1.5 cm.