Lubricate postoperative sutures. How surgeons can treat scars

Surgical operations are quite common nowadays. Most patients agree to them without the slightest fear or doubt, some even perform “optional” operations at their own expense - we are, of course, talking about plastic surgery. And yet, many people are worried not even about how the intervention will go, but about how noticeable the stitches will be after the operation. Do not forget that how quickly and how well the incisions heal largely depends on the care they take during the recovery period.

Basic rules for caring for sutures during the recovery period

Surely you will be told about how to care for sutures after surgery upon discharge, but if the medical staff forgot about this or you don’t remember, we will remind you. The main rule is to always keep the seam clean and dry. If the incision has already healed well enough and there is no open wound, you can wash it plain water with laundry soap. After each hygiene procedure, it is imperative to apply an antiseptic. Brilliant greens, iodine or a solution of potassium permanganate will do. But you should avoid regularly using alcohol or cologne for washing - the whole point is that these compositions dry the skin too much. If there is even the slightest suspicion that the sutures have become contaminated after surgery, they should be washed with hydrogen peroxide. The same procedure is necessary for festering sutures.

Should I wear a bandage or not?

The issue of dressings during the rehabilitation period after surgery should be decided by a doctor. It all depends on the depth and length of the incision, where it is located, how well it heals, and other factors. The patient must listen to his own feelings. For example, if surgeries catch on clothing, a bandage should be applied at least for periods physical activity. Another current question: Should the stitches be treated with special ointments that speed up healing, or is it easier to let everything take its course? You should use folk remedies with caution, but among pharmacological products there are many compounds that have proven themselves to be positive. The most popular product is Levomekol ointment; you can also use any panthenol-based products. After removing the threads, you can treat the scars with special oils and various compounds that accelerate cell regeneration and moisturize the skin.

Time of surgery: will the stitches heal soon?

The question of the duration of rehabilitation after surgery is more than individual. On average, sutures are removed within 7-10 days. In some situations, this period can be extended to two weeks; more is rare, as the risk of threads growing into the skin increases. Remember: Your doctor or nurse should remove your sutures after surgery unless you were instructed otherwise upon discharge. After removing the threads, scar care must be continued. Regardless of how the rehabilitation after the operation goes, the incision site is considered to be completely healed approximately one month after the intervention. Namely, when a clear scar forms.

After surgery, scars and sutures appear on the skin, which persist for a long time. The duration of their healing is determined by the general resistance of the body, the characteristics of the skin and other factors. The main task in the postoperative period is to prevent the development of infection and speed up the regeneration process in all possible ways.

After abdominal surgery and suturing, the healing process includes several stages

Collagen formation or connective tissue fibroblasts. During the healing process, fibroblasts are activated by macrophages. Fibroblasts migrate to the site of damage, and subsequently they bind to fibrillar structures through fibronectin. At the same time, the process of active synthesis of extracellular matrix substances begins, among which collagen is present. The main task of collagen is to eliminate tissue defects and ensure the strength of the emerging scar.
Epithelization of the wound. This process begins as epithelial cells migrate from the edges of the wound to its surface. After epithelization is complete, a kind of barrier to microorganisms is formed, and fresh wounds are characterized by low resistance to infections. A few days after the operation, in the absence of any complications, the wound regains its resistance to infection. If this does not happen, then perhaps the cause was a suture dehiscence after surgery.
Reduction of wound surfaces and wound closure. This result can be achieved due to the effect of wound contraction, which is to a certain extent caused by the contraction of myofibroblasts.

The healing period after surgery is largely determined by the characteristics of the human body. In some situations this process occurs quite quickly, while in other patients it can take quite a while. long time.

Treatment of sutures after surgery

Before answering the question of how long it takes for a suture to heal after abdominal surgery, you need to understand what affects this process. One of the conditions for a successful result is the implementation of correct therapy after the patient has received stitches. In addition, the following factors influence the duration of the postoperative period:

sterility;
materials for processing seams;
regularity of the procedure.

After surgery, maintaining sterility is considered one of the important requirements. This means that seam treatment is only allowed with well-washed hands using disinfected instruments.

How are sutures treated after abdominal surgery, and what disinfectants are the most effective? In fact, the choice of a particular drug is determined by the nature of the injury, and for treatment you can use:

medical alcohol;
hydrogen peroxide;
iodine;
potassium permanganate solution;
brilliant green;
ointments and gels with anti-inflammatory effects.

In the event that it is necessary to process postoperative sutures at home, then for this purpose you can use the following traditional medicine:

tea tree oil in pure form;
tincture of larkspur roots from 20 grams of herbal remedy, 200 ml of water and 1 glass of alcohol;
cream with calendula extract, to which you can add a drop of orange or rosemary oil.

Before using such folk remedies at home, it is recommended to first consult with a specialist.

What affects healing?

The duration of wound healing after suturing depends on the following factors:

the age of the patient - in young people tissue restoration occurs much faster than in older people;
body weight - the wound healing process can slow down if a person is overweight or obese;
nutritional features - lack of energy and plastic material can affect the quality and speed of reparative processes in the wound;
dehydration - lack of fluid in the body can lead to electrolyte imbalance, which slows down the healing of sutures after surgery;
state of blood supply - wound healing occurs much faster if there are a large number of vessels near it;
chronic pathologies can slow down the recovery process and cause various complications;
state of immunity - with a decrease in the body’s defenses, the prognosis of surgical intervention worsens and wounds may fester.

The supply of the required amount of oxygen to the wound is considered one of the main conditions for wound healing, since it participates in the synthesis of collagen and helps phagocytes destroy bacteria. Anti-inflammatory drugs can slow down the healing process in the first few days, but subsequently have virtually no effect on this process.

One of the common reasons for the deterioration of a wound after surgery and a slowdown in its healing process is considered to be secondary infection, which is accompanied by the formation of purulent exudate.

Processing rules

In order for the healing of sutures to take place as quickly as possible without the development of complications, it is necessary to adhere to the following rules:

before starting the procedure, it is necessary to disinfect hands and instruments that may be needed to carry it out;
You should carefully remove the applied bandage, and if it is stuck to the skin, pour peroxide on it;
you need to smear the seam with an antiseptic using a cotton swab or gauze swab;
the bandage must be carefully applied.

It is important to remember that seams should be treated twice a day, but if necessary, the amount can be increased. In addition, it is necessary to carefully examine the wound each time for the presence of any inflammation. It is not recommended to remove dry crusts and scabs from the wound, as this can lead to the appearance of scars on the skin. You should shower with care and do not rub the seam with a sponge that is too hard. If the sutures on the abdomen turn red or purulent exudate begins to ooze from them, you should see a doctor as soon as possible.

Only a doctor can decide when sutures are removed after abdominal surgery. This procedure is carried out under sterile conditions using special instruments and usually 5-10 days after surgery.

Healing products

In order to speed up the resorption and healing of sutures after surgery, you can use antiseptics at home. Experts recommend using them not to treat wet wounds, but only when the healing process has begun. The choice of one or another ointment depends on the nature of the damage and its depth. For shallow superficial wounds, the use of simple antiseptics is recommended, and if complications develop, it is necessary to use drugs containing hormonal components.

How to remove a scar after abdominal surgery, and what ointments are considered the most effective for treating sutures?

Vishnevsky ointment accelerates the removal of pus from the wound;
Levomekol has a combined effect;
Vulnuzan contains natural ingredients and is easy to use;
Levosin destroys bacteria and stops the inflammatory process;
Stellanin helps get rid of tissue swelling and destroy infections, and also accelerates skin regeneration;
Argosulfan has a pronounced bactericidal effect and helps to achieve an analgesic effect;
Actovegin successfully fights the inflammatory process in the wound;
Solcoseryl minimizes the risk of scars and cicatrices.

Such medicines when used correctly, it helps speed up the wound healing process after surgery and avoid infection. It is important to remember that before smearing a postoperative suture on the abdomen, you must consult a doctor. The point is that self-treatment postoperative sutures can result in severe suppuration of the wound and its further inflammation. Compliance with simple rules is the key to successful treatment of postoperative sutures and helps prevent the formation of scars.

One of the most common complications during childbirth is ruptures during childbirth of the soft tissues of the birth canal, which include the cervix, vagina, perineum and external genitalia. Why does this happen and is it possible to avoid stitches? In fact, it is impossible to single out any one reason for breakups. But some of them can be influenced.

First of all, it is necessary to remember that only healthy tissues have sufficient elasticity and stretchability. Inflamed tissue is fragile and swollen, so under any mechanical stress it does not stretch, but tears. Thus, any inflammation of the genital organs the day before can lead to ruptures during childbirth. Therefore, about a month before giving birth, every woman should undergo an examination and take a smear for microflora. If inflammation is detected, treatment must be prescribed followed by monitoring its effectiveness. Another reason for decreased tissue elasticity is previous trauma (scar tissue does not contain elastic fibers and is therefore practically inextensible). So, if during a previous birth a perineal incision was made, as a rule, during subsequent births this is also necessary.

Rapid labor, lack of coordinated work between the woman and the midwife, the large size of the child or incorrect insertion of the presenting part of the fetus is another reason for ruptures during childbirth. In an ideal birth, the fetus moves through the birth canal gradually and body tissues expectant mother manage to adapt to the increasing pressure, they stretch more and more each time. If the body does not have time to adapt, this leads to impaired blood supply and swelling of the tissues of the birth canal, which inevitably ends in rupture.

Sutures after childbirth: repair of tears and incisions

All injuries to the birth canal are subject to mandatory treatment. It begins when examining the birth canal immediately after separation of the placenta. For suturing small cervical tears, anesthesia is not required, since there are no pain receptors in the cervix. If a very deep rupture is found (which is rare), the woman is placed under general anesthesia to examine the uterine cavity to determine the depth of the rupture. Cervical ruptures are sutured with absorbable material.

After examining the cervix, the vaginal walls are examined. If there are few tears during childbirth and they are shallow, then local anesthesia will be enough - the edges of the wound are pricked with painkillers. For deep and multiple ruptures, general anesthesia is used. If epidural anesthesia was used during childbirth, then during suturing the anesthesiologist adds an analgesic to the existing catheter. Tears in the vaginal walls are repaired with absorbable sutures that do not need to be removed.

Small cracks in the external genitalia often do not require suturing, as they heal quickly, but this part of the birth canal is very well supplied with blood, therefore, if the cracks are accompanied by bleeding, they must be sutured after childbirth. Injuries to the external genitalia are very painful, so medical procedures in this area often require general anesthesia. The sutures are placed with very thin absorbable sutures that do not need to be removed.

At the end of the postpartum examination, the integrity of the perineum is restored. Currently, sutures after childbirth are more often applied with absorbable suture material and do not require removal; interrupted non-absorbable sutures are less common.

A separate case of sutures during childbirth are sutures after a caesarean section. Previously, during a caesarean section, the abdomen was cut in the middle “from the navel to the pubis” and interrupted sutures were placed. Now they make a small incision along the pubic hairline. Most often, a special continuous cosmetic suture is applied, less often - interrupted sutures or metal staples. Sutures after cesarean section are removed on the 7th–9th day. At proper care a year after the operation, a thin, thread-like white scar remains, which is easily covered even by bikini bottoms.

Healing of sutures after childbirth

Of course, all young mothers are concerned about the question of how long it takes for stitches to heal after childbirth? So, this process depends on the size of the damage, proper care, general condition organism, techniques and materials used for suturing. When using natural or synthetic absorbable materials, wound healing occurs in 10–14 days, sutures dissolve in about a month. When using metal braces and non-absorbable material, they are removed after childbirth on average on the 5th day in the maternity hospital, before discharge. In this case, wound healing will take longer - from 2 weeks to 1 month.

Stitches in the vagina and cervix

Self-dissolving sutures in the vagina and cervix do not require special care. There is no need to process or remove them, you just need to ensure complete peace and cleanliness. Postpartum discharge is an ideal substrate for reproduction pathogenic bacteria. Therefore, during the first three weeks after birth, it is necessary to especially carefully observe the rules of personal hygiene so that the infection does not enter the genital tract. Before each visit to the toilet and changing a sanitary pad, wash your hands thoroughly with soap and water. After using the toilet, remove the old gasket from front to back. Wash your perineum warm water with soap. The direction of movement and water flow should always be from the genitals to the rectum. After washing the genitals, blot them dry with a napkin or a well-absorbing towel. Such a towel, like underwear, must be changed immediately when soiled by secretions, and every day - if it all remains clean in appearance. Even if you don't feel the urge to urinate, be sure to go to the toilet every 3-4 hours. But you won’t be able to take a bath in the first month after giving birth.

Stitches on the crotch

The presence of seams on the perineum will require even more careful hygiene. In the first two weeks, they hurt quite a lot, it’s hard to walk, and sitting is forbidden; mothers feed them lying down, and they also have to eat lying down or standing. This does not apply to going to the toilet, since you can sit on the toilet already on the first day after the baby is born. Wash your hands and crotch using antiseptic soap. Do not touch the seam area with your hands. In the first days, pads must be changed frequently, sometimes every 2 hours, since in order for the wound to heal as quickly as possible, it must be kept dry. Use special disposable panties for the postpartum period or loose cotton underwear.

While you are in the maternity hospital, the midwife will treat the sutures twice a day, using a solution of potassium permanganate or brilliant green. Removing threads is a low-painful procedure that significantly relieves discomfort.

In the first days after childbirth, it is necessary to delay bowel movements; for this it is better not to eat cereals, fruits, vegetables and other foods that stimulate bowel movements. This usually does not cause big problems, since a cleansing enema is performed before childbirth. After 3 days, laxatives will help restore stool if necessary. To avoid constipation, you can drink a tablespoon before meals vegetable oil, then the stool will become soft and will not affect the healing of the sutures.

After the stitches are removed and discharged from the hospital, if the damaged areas are healing well, there is no need for treatment. It is allowed to sit on something hard only after 2 weeks and only on the healthy buttock opposite the side of the incision.

Do the following exercise several times throughout the day: pull in the muscles of the vagina, perineum and anus. Stay in this state for a few seconds, and then relax your muscles. Then repeat everything again. The exercise can be done for 5–10 minutes. It stimulates blood flow to organs and promotes better healing. The knots of absorbable sutures fall off around the third week. Chamomile infusions will help relieve pain and itching in the suture area. You can wash yourself with this infusion, or you can moisten a gauze pad with it and apply it to the wound for 1–2 hours. Some women use cold compresses. To do this, put crushed ice in a sterile rubber glove. The glove is applied to the wound for 20–30 minutes. During the first month, try not to sit or stand for long periods of time. It is better to lie on your side and sit on a pillow or circle. At the end of the first month after giving birth, you should visit a gynecologist in antenatal clinic. He will examine the sutures and remove any remaining absorbable sutures if necessary.

Sutures after caesarean section

Stitches after caesarean section. Women who have had C-section, you must be prepared for the fact that pain in the area of the postoperative wound will bother you for 2–3 weeks. In the first days you have to use painkillers. During this time, when you walk, you need to wear a postoperative bandage or tie your stomach with a diaper.

You should not lie in bed, since getting up early and moderate activity (caring for the baby, walking along the corridor) not only improves intestinal motility, but also contributes to better contraction of the uterus and faster healing of the postoperative wound. While you are in the hospital, the treatment nurse will clean the stitches with an antiseptic solution and change the dressing daily. It is important to protect this dressing from water, so cover it with a towel when washing. You should ensure that the clothing surrounding the wound is always clean. Underwear, including nightgown changes every day, and even more often as it gets dirty.

After the stitches are removed, you can be discharged home and shower. As a rule, additional seam processing is no longer necessary. For the first 2 weeks after discharge, the skin should be washed with soap and water 2 times a day. After washing the seams, they should be carefully blotted dry with a disposable or freshly washed towel.

Until the wound has completely healed, it is recommended to wear lightweight, breathable underwear. Thick underwear can damage the seam after a cesarean section. The best option are loose trousers made of cotton, with high waist. In the first month after giving birth, a new mother is not recommended to lift weights more than the weight of the child. You also need to wear a special postpartum bandage. At first, the scar may be very itchy, this is due to the healing process, you just need to be patient. By the end of the second week after childbirth, you can begin to lubricate the scar with creams and ointments that improve skin restoration.

Complications after childbirth

A feeling of heaviness, fullness, or pain in the perineum may indicate accumulation of blood (formation of a hematoma) in the area of injury. This usually happens in the first three days after giving birth while still in the maternity hospital, so you should immediately report this feeling to your doctor.

Dehiscence of sutures most often occurs in the first days or immediately after their removal, rarely later. The reason may be early sitting down, sudden movements, violation of sterility and poor comparison of tissues during suturing, as well as non-compliance with hygiene rules of the postpartum period. This is a rare complication that occurs with serious deep ruptures of the perineum. If, after being discharged home, the suture area begins to bleed, hurt, turn red, or purulent discharge appears, you should urgently consult a gynecologist, as most likely an infection has occurred and inflammation has occurred. To treat, the wound will need to be treated with various antiseptics, and sometimes special surgical treatment may be required.

Complications after childbirth require immediate treatment, as they can lead to very serious consequences - postpartum peritonitis (inflammation of the abdominal cavity) or sepsis (general infectious lesion throughout the body, distributed through the blood). Therefore, if you are concerned about anything about your condition, be sure to consult a doctor.

Information about the types and healing process of postoperative sutures. It also tells what actions need to be taken in case of complications.

After a person has undergone surgery, scars and stitches remain for a long time. From this article you will learn how to properly process a postoperative suture and what to do in case of complications.

Types of postoperative sutures

A surgical suture is used to connect biological tissues. The types of postoperative sutures depend on the nature and scale of the surgical intervention and are:

bloodless, which do not require special threads, but are glued together using a special adhesive
bloody, which are stitched with medical suture material through biological tissues

Depending on the method of applying bloody sutures, there are the following types:

simple nodal- the puncture has a triangular shape, which holds the suture material well
continuous intradermal- most common which provides a good cosmetic effect
vertical or horizontal mattress - used for deep, extensive tissue damage
purse string – intended for plastic fabrics
entwining - as a rule, serves to connect vessels and hollow organs

The following techniques and instruments are used for suturing vary:

manual, when applying which a regular needle, tweezers and other instruments are used. Suture materials - synthetic, biological, wire, etc.
mechanical carried out using a device using special brackets

The depth and extent of the injury dictates the method of suturing:

single-row - the seam is applied in one tier
multilayer - application is made in several rows (muscle and vascular tissues are first connected, then the skin is sutured)

In addition, surgical sutures are divided into:

removable- after the wound has healed, the suture material is removed (usually used on covering tissue)
submersible- cannot be removed (suitable for joining internal tissues)

Materials that are used for surgical sutures can be:

absorbable - removal of suture material is not required. Typically used for ruptures of mucous and soft tissues
non-absorbable - removed after a certain period of time determined by the doctor

When applying sutures, it is very important to connect the edges of the wound tightly so that the possibility of cavity formation is completely excluded. Any type of surgical sutures requires treatment with antiseptic or antibacterial drugs.

How and with what should I treat a postoperative suture for better healing at home?

The healing period of wounds after surgery largely depends on the human body: for some this process occurs quickly, for others it takes a longer time. But the key to a successful result is proper therapy after suturing. The timing and nature of healing are influenced by the following factors:

sterility
materials for processing the suture after surgery
regularity

One of the most important requirements for postoperative injury care is maintaining sterility. Treat wounds only with thoroughly washed hands using disinfected instruments.

Depending on the nature of the injury, postoperative sutures are treated with various antiseptic agents:

potassium permanganate solution (it is important to follow the dosage to avoid the possibility of burns)
iodine (in large quantities can cause dry skin)
brilliant green
medical alcohol
fucarcin (difficult to wipe off from the surface, which causes some inconvenience)
hydrogen peroxide (may cause a slight burning sensation)
anti-inflammatory ointments and gels

Folk remedies are often used at home for these purposes:

tea tree oil (pure)
tincture of larkspur roots (2 tbsp., 1 tbsp. water, 1 tbsp. alcohol)
ointment (0.5 cups of beeswax, 2 cups of vegetable oil, cook over low heat for 10 minutes, let cool)
cream with calendula extract (add a drop of rosemary and orange oils)

Before using these medications, be sure to consult your doctor. In order for the healing process to occur as quickly as possible short terms without complications, it is important to follow the rules for processing seams:

disinfect hands and tools that may be needed
carefully remove the bandage from the wound. If it sticks, pour peroxide on it before applying antiseptic.
Using a cotton swab or gauze swab, lubricate the seam with an antiseptic drug
apply a bandage

In addition, do not forget to comply with the following conditions:

carry out processing twice a day, if necessary and more often
regularly carefully examine the wound for inflammation
To avoid the formation of scars, do not remove dry crusts and scabs from the wound
When showering, do not rub the seam with hard sponges
If complications occur (purulent discharge, swelling, redness), consult a doctor immediately

How to remove postoperative sutures at home?

The removable postoperative suture must be removed on time, since the material used to connect the tissue acts as a foreign body to the body. In addition, if the threads are not removed in a timely manner, they can grow into the tissue, leading to inflammation.

We all know that a postoperative suture must be removed by a medical professional in suitable conditions using special tools. However, it happens that there is no opportunity to visit a doctor, the time for removing the stitches has already come, and the wound looks completely healed. In this case, you can remove the suture material yourself.

To get started, prepare the following:

antiseptic drugs
sharp scissors (preferably surgical, but you can also use nail scissors)
dressing
antibiotic ointment (in case of infection in the wound)

Perform the seam removal process as follows:

disinfect instruments
wash your hands thoroughly up to the elbows and treat them with an antiseptic
choose a well-lit place
remove the bandage from the seam
using alcohol or peroxide, treat the area around the seam
Using tweezers, gently lift the first knot slightly
holding it, use scissors to cut the suture thread
carefully, slowly pull out the thread
continue in the same order: lift the knot and pull the threads
make sure to remove all suture material
treat the seam area with an antiseptic
apply a bandage for better healing

If you remove postoperative sutures yourself, in order to avoid complications, strictly follow these requirements:

You can remove only small superficial seams yourself
Do not remove surgical staples or wires at home
make sure the wound is completely healed
if bleeding occurs during the process, stop the action, treat with an antiseptic and consult a doctor
protect the seam area from ultraviolet radiation, since the skin there is still too thin and susceptible to burns
avoid the possibility of injury to this area

What to do if a seal appears at the site of the postoperative suture?

Often, after the operation, a patient experiences a seal under the suture, which is formed due to the accumulation of lymph. As a rule, it does not pose a threat to health and disappears over time. However, in some cases complications may arise in the form of:

inflammation- accompanied by painful sensations in the suture area, redness is observed, and the temperature may rise
suppuration- when the inflammatory process is advanced, pus may leak from the wound
the formation of keloid scars is not dangerous, but has an unaesthetic appearance. Such scars can be removed using laser resurfacing or surgery.

If you observe the listed signs, contact the surgeon who operated on you. And if this is not possible, go to the hospital at your place of residence.

If you see a lump, consult a doctor

Even if it later turns out that the resulting lump is not dangerous and will resolve on its own over time, the doctor must conduct an examination and give his opinion. If you are convinced that the postoperative suture seal is not inflamed, does not cause pain and there is no purulent discharge, follow these requirements:

Follow the rules of hygiene. Keep bacteria away from the injured area
treat the seam twice a day and change the dressing material promptly
When showering, avoid getting water on the unhealed area
don't lift weights
make sure that your clothes do not rub the seam and the areola around it
Before going outside, apply a protective sterile bandage
Do not under any circumstances apply compresses or rub yourself with various tinctures on the advice of friends. This can lead to complications. A doctor must prescribe treatment

Compliance with these simple rules is the key to successful treatment of suture seals and the possibility of getting rid of scars without surgical or laser technologies.

The postoperative suture does not heal, it is red, inflamed: what to do?

One of a number of postoperative complications is inflammation of the suture. This process is accompanied by such phenomena as:

swelling and redness in the suture area
the presence of a seal under the seam that can be felt with your fingers
temperature rise and blood pressure
general weakness and muscle pain

The reasons for the appearance of the inflammatory process and further non-healing of the postoperative suture can be different:

infection in a postoperative wound
During the operation, the subcutaneous tissues were injured, resulting in the formation of hematomas
suture material had increased tissue reactivity
in overweight patients, wound drainage is insufficient
low immunity of the operated patient

Often there is a combination of several of the listed factors that may arise:

due to an error by the operating surgeon (instruments and materials were not processed sufficiently)
due to patient non-compliance with postoperative requirements
due to indirect infection, in which microorganisms are spread through the blood from another source of inflammation in the body

If you see redness in the suture, consult a doctor immediately

In addition, the healing of a surgical suture largely depends on individual characteristics body:

weight- y fat people the wound may heal more slowly after surgery
age - tissue regeneration in at a young age happens faster
nutrition - lack of proteins and vitamins slows down the recovery process
chronic diseases- their presence prevents rapid healing

If you notice redness or inflammation of a postoperative suture, do not delay visiting a doctor. It is the specialist who must examine the wound and prescribe correct treatment:

remove stitches if necessary
washes the wounds
install drainage to drain purulent discharge
will prescribe the necessary medications for external and internal use

Timely implementation of the necessary measures will prevent the likelihood of severe consequences (sepsis, gangrene). After medical procedures have been performed by your attending physician, to speed up the healing process at home, follow these recommendations:

treat the suture and the area around it several times a day with the medications prescribed by the attending physician
While showering, try not to touch the wound with a washcloth. When you get out of the bath, gently blot the seam with a bandage.
change sterile dressings on time
take multivitamins
add extra protein to your diet
do not lift heavy objects

In order to minimize the risk of an inflammatory process, before surgery it is necessary to take preventive measures:

boost your immunity
sanitize your mouth
identify the presence of infections in the body and take measures to get rid of them
strictly observe hygiene rules after surgery

Postoperative fistula: causes and methods of control

One of negative consequences after surgery is postoperative fistula, which is a channel in which purulent cavities are formed. It occurs as a consequence of the inflammatory process when there is no outlet for purulent fluid.
The reasons for the appearance of fistulas after surgery can be different:

chronic inflammation
the infection is not completely eliminated
rejection by the body of non-absorbable suture material

The last reason is the most common. The threads that connect tissues during surgery are called ligatures. Therefore, a fistula that occurs due to its rejection is called ligature. Around the thread is formed granuloma, that is, a compaction consisting of the material itself and fibrous tissue. Such a fistula is formed, as a rule, for two reasons:

entry of pathogenic bacteria into the wound due to incomplete disinfection of threads or instruments during surgery
patient's weak immune system, due to which the body weakly resists infections, and there is a slow recovery after the introduction of a foreign body

A fistula can appear in different postoperative periods:

within a week after surgery
in a few months

Signs of fistula formation are:

redness in the area of inflammation
the appearance of compactions and tubercles near or on the seam
painful sensations
discharge of pus
temperature rise

After surgery, a very unpleasant phenomenon may occur - a fistula.

If you experience any of the above symptoms, be sure to consult a doctor. If measures are not taken in time, the infection can spread throughout the body.

Treatment of postoperative fistulas is determined by the doctor and can be of two types:

conservative
surgical

The conservative method is used if the inflammatory process has just begun and has not led to serious disorders. In this case, the following is carried out:

removal of dead tissue around the seam
washing the wound from pus
removing the outer ends of the thread
patient taking antibiotics and immune-boosting drugs

The surgical method includes a number of medical measures:

make an incision to drain the pus
remove the ligature
wash the wound
if necessary, perform the procedure again after a few days
if there are multiple fistulas, you may be prescribed complete excision of the suture
the stitches are reapplied
a course of antibiotics and anti-inflammatory drugs is prescribed
complexes of vitamins and minerals are prescribed
standard therapy prescribed after surgery is carried out

IN lately appeared new way treatment of fistulas - ultrasound. This is the most gentle method. Its disadvantage is the length of the process. In addition to the methods listed, healers offer folk remedies for the treatment of postoperative fistulas:

mumiyo dissolve in water and mix with aloe juice. Soak a bandage in the mixture and apply to the inflamed area. Keep it for several hours
wash the wound with a decoction St. John's wort(4 tablespoons of dry leaves per 0.5 liters of boiling water)
take 100 g of medical tar, butter, flower honey, pine resin, crushed aloe leaf. Mix everything and heat in a water bath. Dilute with medical alcohol or vodka. Apply the prepared mixture around the fistula, cover with film or plaster
Apply a sheet to the fistula at night cabbage

However, do not forget that folk remedies are only auxiliary therapy and do not cancel a visit to the doctor. To prevent the formation of postoperative fistulas it is necessary:

Before the operation, examine the patient for the presence of diseases
prescribe antibiotics to prevent infection
carefully handle instruments before surgery
avoid contamination of suture materials

Ointments for healing and resorption of postoperative sutures

For resorption and healing of postoperative sutures, antiseptic agents (brilliant, iodine, chlorhexidine, etc.) are used. Modern pharmacology offers other drugs of similar properties in the form of ointments for local use. Using them for healing purposes at home has a number of advantages:

availability
wide spectrum of action
the fatty base on the surface of the wound creates a film that prevents tissue from drying out
skin nutrition
ease of use
softening and lightening of scars

It should be noted that for wet wounds skin the use of ointments is not recommended. They are prescribed when the healing process has already begun.

Based on the nature and depth of skin damage, different types of ointments are used:

simple antiseptic(for shallow superficial wounds)
containing hormonal components (for extensive, with complications)

Vishnevsky ointment- one of the most affordable and popular pulling agents. Promotes accelerated release from purulent processes
levomekol- has a combined effect: antimicrobial and anti-inflammatory. Is an antibiotic wide range. Recommended for purulent discharge from the suture
vulnuzan- a product based on natural ingredients. Apply to both wound and bandage
levosin- kills microbes, removes inflammation, promotes healing
stellanine- a new generation ointment that removes swelling and kills infection, stimulates skin regeneration
eplan- one of the most powerful means of local treatment. Has an analgesic and anti-infective effect
solcoseryl- Available in the form of a gel or ointment. The gel is used when the wound is fresh, and the ointment when healing has begun. The drug reduces the likelihood of scar formation. Better to put under a bandage
actovegin- more cheap analogue solcoseryl. Successfully fights inflammation, practically does not cause allergic reactions. Therefore, it can be recommended for use by pregnant and lactating women. Can be applied directly to damaged skin
agrosulfan- has a bactericidal effect, has an antimicrobial and analgesic effect

Ointment for treating seams

naftaderm - has anti-inflammatory properties. Additionally, it relieves pain and softens scars.
Contractubex - used when the suture begins to heal. Has a softening, smoothing effect in the scar area
Mederma - helps increase tissue elasticity and lightens scars

The listed medications are prescribed by a doctor and used under his supervision. Remember that you cannot self-medicate postoperative sutures in order to prevent wound suppuration and further inflammation.

Plaster for healing postoperative sutures

One of effective means for the care of postoperative sutures is a plaster made on the basis of medical silicone. This is a soft self-adhesive plate that is fixed to the seam, connecting the edges of the fabric, and is suitable for minor damage to the skin.
The advantages of using the patch are as follows:

prevents pathogens from entering the wound
absorbs discharge from the wound
does not cause irritation
breathable, allowing the skin under the patch to breathe
Helps soften and smooth out scars
retains moisture well in fabrics, preventing drying out
prevents scar enlargement
easy to use
There is no skin injury when removing the patch

Some patches are waterproof, allowing the patient to shower without risk of suture damage. The most commonly used patches are:

cosmopore
mepilex
mepitak
hydrofilm
fixopore

To achieve positive results in the healing of postoperative sutures, this medical product must be applied correctly:

remove the protective film
apply the adhesive side to the seam area
change every other day
periodically peel off the patch and check the condition of the wound

We remind you that before using any pharmacological agent, you must consult your doctor.

Women's Beauty and Health Club

No matter how careful and experienced the surgeon is, no matter what modern suture materials he uses, a scar inevitably remains at the site of any surgical incision - a special structure made of connective (fibrous) tissue. The process of its formation is divided into 4 sequential stages, and significant internal changes after fusion of the wound edges continue for at least another year, and sometimes much longer - up to 5 years.

What happens at this time in our body? How to speed up healing, and what needs to be done at each stage to ensure that the scar remains as thin and invisible as possible?TecRussia.ru explains in detail and gives useful recommendations:

Stage 1: epithelization of the skin wound

It begins as soon as the damage is received (in our case, a surgical incision) and continues for 7-10 days.

Immediately after injury, inflammation and swelling occurs. Macrophages emerge from adjacent vessels into the tissue - “eaters”, which absorb damaged cells and clean the edges of the wound. A blood clot is formed - in the future it will become the basis for scarring.
On day 2-3, fibroblasts are activated and begin to multiply - special cells that “grow” new collagen and elastin fibers, and also synthesize the intercellular matrix - a kind of gel that fills the intradermal cavities.

At the same time, vascular cells begin to divide, forming numerous new capillaries in the damaged area. Our blood always contains protective proteins - antibodies, the main function of which is to fight foreign agents, so a developed vascular network becomes an additional barrier to possible infection.
As a result of these changes, granulation tissue grows on the injured surface. It is not very strong and does not connect the edges of the wound tightly enough. With any, even slight force, they can separate - even though the top of the cut is already covered with epithelium.

At this stage, the work of the surgeon is very important - how smoothly the skin flaps are aligned when applying a suture, and whether there is excessive tension or “tucking” in them. Also, careful hemostasis (stopping bleeding) and, if necessary, drainage (removing excess fluid) are important for the formation of a proper scar.

Excessive swelling, hematoma, and infection disrupt normal scarring and increase the risk of developing rough scars. Another threat during this period is an individual reaction to the suture material, which usually manifests itself in the form of local edema.
All necessary treatment of the surgical wound at this stage is done by a doctor or nurse under his supervision. You can’t do anything on your own, and it doesn’t make sense to interfere with the natural healing process yet. The maximum that a specialist can recommend after removing the stitches is to fix the edges with a silicone patch.

Stage 2: “young” scar or active fibrillogenesis

Occurs between 10 and 30 days after surgery:

Granulation tissue matures. At this time, fibroblasts are actively synthesizing collagen and elastin, the number of fibers is growing rapidly - hence the name of this phase ( Latin word“fibril” means “fiber”) - they are located chaotically, due to which the scar looks quite voluminous.
But there are fewer capillaries: as the wound heals, the need for an additional protective barrier disappears. But, despite the fact that the number of vessels in general decreases, there are still relatively many of them, so the developing scar will always be bright pink. It is easily stretchable and can be injured under excessive loads.

The main danger at this stage is that the already fused sutures may still come apart if the patient is overly active. Therefore, it is so important to carefully follow all postoperative recommendations, including those related to lifestyle, physical activity, and medication - many of them are aimed precisely at providing conditions for normal, uncomplicated scarring.

As prescribed by your doctor, you can begin using external creams or ointments to treat the developing seam. As a rule, these are agents that accelerate healing: Actovegin, Bepanten and the like.
In addition, hardware and physical procedures aimed at reducing swelling and preventing hypertrophy of fibrous tissue give good results: Darsonval, electrophoresis, phonophoresis, magnetic therapy, lymphatic drainage, microcurrents, etc.

Stage 3: formation of a durable scar - “maturation”

During this period - 30 - 90 days after surgery - appearance the scar gradually returns to normal:

If at earlier stages the collagen and elastin fibers were arranged randomly, then during the third phase they begin to rearrange, oriented in the direction of greatest stretching of the edges of the incision. There are fewer fibroblasts, and the number of blood vessels decreases. The scar thickens, decreases in size, reaches its maximum strength and turns pale.
If at this time fresh connective tissue fibers are subjected to excessive pressure, tension or other mechanical stress, the process of restructuring collagen and removing its excess is disrupted. As a result, the scar may become rough, or even acquire the ability to constantly grow, turning into. In some cases, this is possible even without exposure external factors- due to the individual characteristics of the body.

At this stage, there is no need to stimulate healing; it is enough for the patient to avoid excessive loads to the operated area.

If a tendency towards excessive fibrosis becomes apparent, the doctor will prescribe injections to reduce scarring activity - usually corticosteroid-based drugs (hydrocortisone or similar). Collagenase also gives good results. In less difficult cases, and also for preventive purposes, non-steroidal external agents are used -, etc.
It is important to understand that such therapy should be carried out exclusively under the supervision of a dermatologist or surgeon. If you prescribe hormonal ointments or injections yourself, just because the appearance of the suture does not meet expectations or does not look like a photo from the Internet, you can significantly disrupt the process of tissue restoration, up to their partial atrophy.

Stage 4: final restructuring and formation of a mature scar

Begins 3 months after surgery and continues for at least 1 year:

The vessels that penetrated the ripening scar tissue at the previous stages almost completely disappear, and the collagen and elastin fibers gradually acquire their final structure, lining up in the direction of the main forces acting on the wound.
Only at this stage (at least 6-12 months after surgery) can the condition and appearance of the scar be assessed, as well as plan any corrective measures, if necessary.

Here, the patient is no longer required to take such serious precautions as in the previous ones. In addition, it is possible to carry out a wide range of additional corrective procedures:

Surgical threads are usually removed much earlier than the surface of the scar is completely formed - otherwise the scarring process may be disrupted due to excessive compression of the skin. Therefore, immediately after removing the sutures, the edges of the wound are usually fixed with special adhesives. The surgeon decides how long to wear them, but most often the fixation period coincides with the “average” period of scar formation. With this care, the mark from the surgical incision will be the thinnest and most invisible.
Another, less known, method that is used mainly on the face is. “Switching off” the adjacent facial muscles allows you to avoid tension on the developing scar without the use of a patch.
Aesthetic defects of mature scars do not respond well to conservative treatment. If hormonal injections and external ointments used earlier did not give the desired result, then at the 4th stage and upon its completion, techniques based on mechanical removal of fibrous excess are used: dermabrasion, peelings and even surgical excision.

Briefly about the most important things:

Stage of scar formation and its timing	Main Features	Therapeutic and preventive measures
1. Epithelization of the skin wound as a response to tissue damage (the first few days after surgery)	At the site of injury, the body releases biologically active substances that cause the development of edema, and also trigger the processes of cell division and collagen synthesis.	Careful treatment and suturing of the incision (performed by a surgeon). After the stitches are removed, they can be replaced with a plaster to avoid unnecessary tension on the edges of the wound.
2. “Young” scar (1-4 weeks after surgery)	The production of a significant, usually even excessive amount of collagen continues. Vasodilation and increased blood flow at the site of injury contribute to the formation of a voluminous, soft, red or pink scar.	Application of healing ointments (Solcoseryl, etc.) In the presence of severe swelling and/or the threat of proliferation of fibrous tissue - corrective hardware procedures (microcurrents, lymphatic drainage, etc.)
3. “Maturation” of the scar (from 4th to 12th week)	Excess connective tissue gradually dissolves, blood flow weakens. The scar thickens and fades - normally it becomes flesh-colored to white.	The use of non-hormonal ointments to prevent severe scarring. If there are obvious signs of keloid formation, injections or external application of corticosteroids are required.
4. Final tissue restructuring (from 13 weeks to 1 year).	Collagen and elastin fibers are aligned along the lines of greatest tension in the skin. In the absence of complications, a thin whitish stripe is formed from the loose, voluminous and elastic scar formation, almost invisible from the outside.	Towards the end of this stage, if necessary, you can use any mechanical methods of scar correction: grinding, peeling, surgical excision.

In addition to the local factors mentioned above, the healing processes of surgical incisions largely depend on the following circumstances:

Age. The older a person is, the slower the damaged tissues heal - but the more accurate the final result will be. Statistically, rough hypertrophic and keloid scars occur more often in patients under 30 years of age.
Heredity. The predisposition to forming large, uncontrollably growing scars often runs in families. In addition, people with dark and dark skin to a greater extent prone to excessive division of connective tissue cells.

Also, the following can disrupt the normal wound healing processes and worsen the final condition of the scar:

obesity or, conversely, underweight;
diseases of the endocrine system (hypo- and hyperthyroidism, diabetes mellitus);
systemic collagenoses (systemic lupus erythematosus, systemic scleroderma, etc.);
use of medications (corticosteroids, cytostatics, anti-inflammatory drugs).