How to understand that the seams have resolved. Stitches after childbirth: how to speed up healing

After the birth of a child, a woman faces many troubles and their consequences. One of these problems, which brings considerable discomfort to the mother, is the seam after childbirth. It is characterized by constant anxiety, complications in the form of suppuration or inflammation.

How many stitches heal after childbirth cannot be said with accuracy. For each situation, this period is individual. He stops bothering someone after a few days, someone suffers for a couple of months. Doctors are sure that proper care and proper manipulations will help to significantly speed up the process in time. Depending on the type of thread used, care should be different, but always thorough and regular.

Joints that can be very painful exist in several forms: on the perineum, on the cervix, and in the vagina. They are outside and outside. Connections of fabrics in separate zones occur with all kinds of threads. It is important to find out how best to take care of them and what features they have.

If on the cervix:

• occur during the birth of a large child;
• the doctor does not use an anesthetic drug, as the area of ​​\u200b\u200bthe uterus loses sensitivity for a while;
• absorbable materials are used: PHA, vicryl, catgut, caproag and others;
• no need to remove and process anything, after a few days they resolve themselves;
• You do not have to worry about the complexity of care or the likelihood of complications.

If on the perineum:

• occur with the natural birth of a child or during the intervention of a surgeon;
• the depth of the incision requiring suturing may be different (only the skin is damaged, except for the skin, the muscles are also affected, or the depth of the damage reaches the rectum);
• lidocaine - an anesthetic in such cases;
• for a long time they are disturbed by unpleasant sensations, then in a day the pain will not go away;
• self-absorbable threads are not used, silk and nylon materials are popular in use;
• for quick healing, you need to move less, monitor the cleanliness of the body and treat the damaged areas with a special antiseptic.

If in the vagina:

• are due to birth injuries, as well as gaps of varying degrees and depths;
• relieve pain in the power of novocaine and lidocaine;
• stitches on damaged tissue are performed with catgut;
• malaise worries for several days;
• no special care is required for this area.

External ones are much more painful than internal ones and heal longer; they need careful and timely care.

Ignoring this requirement will lead to various complications (inflammation, suppuration, infection).

overgrowth rate

When will the stitches dissolve after application? Do the threads fall off on their own after healing? How long does it take for the internal stitches imposed by the doctor to dissolve? Young mothers are concerned about these and other issues.

There are several points that affect the speed of dealing with unpleasant symptoms:

1. Self-absorbable sutures after childbirth have an impressive healing rate, taking a couple of weeks. Scars return to normal after a month and do not require additional manipulations.
2. It is impossible to say with accuracy how long the external seams will disturb after application. When they are applied, other materials are used, the reaction of the body to which cannot be completely predicted. Stitches are removed after 5 or 6 days, tissue tightening does not occur quickly and takes different times - from two weeks to one month.
3. The entry of microbes or infections into an open area can significantly slow down the healing process. To avoid this problem, you should carefully monitor the cleanliness of your body, as well as avoid intimate relationships with a partner (sex is the main cause of infection and increases the risk of infection for a girl in the first time after the birth of a child).

How to take care of yourself

Experienced mothers know how to speed up the process of restoring external seams after childbirth, having in their arsenal: special-purpose creams and gels, rinsing wounded surfaces with decoctions of herbs and flowers (do not forget about the healing properties of chamomile, sage, calendula), the use of antiseptics and antibacterial soap without fragrances and dyes.

On your own, you can speed up the recovery process and improve your general condition by following simple rules:

1. Make sure that the clinic workers treat the problem area with a solution of potassium permanganate or other available means twice a day.
2. Remember to change sanitary pads as needed.
3. Buy disposable special underwear or give preference to soft and natural fabrics.
4. If you want to quickly return a flat stomach, at first it is forbidden to wear tight panties, which tend to put some pressure on the organs and disrupt blood circulation.
5. Do not sit (especially on a soft surface) to eliminate the risk of breaking the connection.
6. It is necessary to carefully monitor the cleanliness of the intimate area, using clean running water, antibacterial soap (or shower gel).
7. If you can’t shower and wash thoroughly, you can purchase unscented antibacterial wet wipes or a clear antiseptic spray and use them in extreme cases.
8. It is necessary not to forget to empty yourself, this will help to slightly relieve the load and aching sensations.
9. It is important to eat right and drink plenty of water to prevent constipation and other gastrointestinal problems.
10. Forget about sugar, pastries and carbonated drinks, such food slows down the healing process of the skin.
11. The attending physician is obliged to give his recommendations to the patient regarding the care of damaged junctions. Such advice must be followed in order to avoid complications in the future.
12. Forget about lifting weights.

If a woman begins to adhere to these tips, the recovery process will be much faster and safer. But, if you do not listen to your body and ignore its signals in every possible way, you can learn from your own experience about a number of complications that are possible at this stage.

The likelihood of complications

For some reason, it happens that for a long time after surgery, the mother still feels severe pain, itching, or notices bleeding. The following manifestations may alert:

• healing of scars occurs very slowly or does not occur at all, attacks of cutting sensations are disturbing (warming procedures and ointments are prescribed);
• stitches previously applied with threads diverge (self-treatment is contraindicated, an urgent need to call a doctor; it is recommended either to re-apply the threads, or to use ointments and suppositories on your own);
• worried about severe itching and burning (do not worry, this is a natural phenomenon; it is recommended to rinse the skin with a little warm water more often and take a lying position);
• festering of the wound occurs: brown or green discharge should alert, as well as a sharp and unpleasant odor (a very dangerous symptom that requires intervention by a doctor);
• bleeding occurs after lifting heavy or sitting (requires a doctor's consultation, possibly re-suturing).

If the stitches after childbirth hurt for a very long time, violating the standard terms, and the sensations are unbearable, you should urgently seek medical help from an experienced specialist.

When and how to film

If the complications are bypassed and everything proceeds within the normal range, the superimposed stitches are removed on the 5th-6th day, this date is agreed in advance with the doctor. When a mother and baby stay longer in the maternity hospital, the procedure is carried out right there, if they were discharged earlier, it is necessary to arrive at the appointed time. Given the pain threshold of the patient, the medical worker has the right to suggest the use of anesthesia, but this is extremely rare. Removal should not cause discomfort, since everything has already healed. All mom feels is a slight burning and tingling sensation.

You should not be afraid of this, everything is already behind. The main thing is competent self-care before that, regular visits to doctors and attentiveness to yourself and your own health. Cleanliness, peace, less stress, examinations by a doctor are simple requirements, but mandatory points that should be followed.

But even when a certain complication has been discovered, there is no need to panic and despair. Timely help of a specialist will easily eliminate the problem that has arisen in a fairly short period of time.

Every expectant mother often thinks about How long does it take for stitches to dissolve after childbirth? And what can she do to speed up this process. After all, postpartum sutures can heal for weeks, or even months. It is believed that men are proud that they should fight, and women should give birth. Sometimes after the hospital there are no less serious scars than after military operations. This happens because not all women in labor know how to properly care for stitches after childbirth.

Stitches after childbirth are quite common. Most often this happens in women who have become a mother for the first time. Postpartum sutures are applied in 4 cases:

1. In natural childbirth, if the tissues of the uterus have torn. This happens if the uterus does not open enough during contractions and the fetus is pushed out prematurely;
2. After caesarean section. Such seams must be applied;
3. During rupture of the vaginal walls, which are damaged for the same reasons that the cervix ruptures;
4. With ruptures of the perineum. Perineal injuries are the most common. This unpleasant phenomenon occurs under various circumstances.

There are also three categories of perineal tear:

1. Damaged posterior perineal joint;
2. Torn muscles and skin of the pelvic floor;
3. The walls of the rectum, muscles and skin.

How long does it take to heal different types of sutures?

Depending on the type of rupture or incision, both self-absorbable sutures and those from which the threads need to be removed can be applied. Recently, for suturing, a technique borrowed from cosmetology has been used. This is done if the edges of the cut or tear are sufficiently even. This is an intradermal suture, the thread of which runs in a zigzag manner and comes out only at the beginning and end. As a result, the scar heals quickly enough and over time is almost invisible.

Depending on the situation, a different method of suturing is sometimes used.. With the help of absorbable material, both muscles and skin are sutured with one thread. Thanks to this method, the healing process is the most painless compared to other types of sutures. This happens thanks to well-matched tissues.

The material of which the threads are composed directly depends on the time of suture resorption:

1. Stitches from catgut threads will resolve from 30 to 120 days. In this case, it all depends on the thickness and place of application of the thread.
2. Lavsan threads distributed over different periods of resorption. Basically it is from 10 to 50 days.
3. Vicryl threads will resolve in 60 to 90 days.

What nuances should a woman in labor observe in order to avoid complications?

The main complications of the sutures are their divergence and the penetration of infection into them. Internal seams are practically not amenable to discrepancy. The failure of the seams should be feared if they are on the perineum. Basically, perineal wounds diverge for four reasons:

1. Premature sudden movements;
2. Early sitting down;
3. Wound infection;
4. Early, active sex life.

For better and faster healing of sutures on the perineum, it is worth carrying out meticulous wound care. You must provide maximum comfort and protection. Here are some ways to properly care for a wound:

1. First of all, give up tight underwear and wear only loose, preferably cotton;
2. Be sure to change sanitary pads every 2 hours;
3. Every morning and evening, thoroughly wash the seams with soap and wash with clean, warm water every time you visit the ladies' room;
4. Dry the perineum with a towel after each wash;
5. Every day, be sure to clean the wound with antiseptics;
6. Also, if possible, avoid constipation, so as not to put pressure on the perineum once again.

In some cases, for example, during surgery, as well as after childbirth, absorbable sutures are required. For this, a special material is used. There are many types of absorbable threads. The healing time of such wounds depends on many factors. So how long do self-absorbable sutures absorb?

The main types of seams

To answer this question, it is necessary to clarify what main types of seams exist. As a rule, this is:

1. Internal. Similar seams are superimposed on injuries resulting from mechanical stress. Certain types of tissues are used to connect tissues at the rupture site. Such self-absorbable sutures heal quite quickly. Often they are applied to women after childbirth on the cervix. In this case, anesthesia is not required, since this part of the reproductive organ is devoid of sensitivity.
2. Outdoor. They can also be applied using absorbable material. After childbirth, such sutures are made at rupture or during dissection of the perineum, as well as after operations. If conventional material is used, then its removal is required 5-7 days after surgery.

It is worth considering that self-absorbable sutures can heal after a few weeks. It all depends on the type of material and its composition.

What are absorbable sutures

Self-absorbable sutures are almost always applied. It is extremely rare for wound healing to use surgical material that is resistant to hydrolysis. Absorbable sutures are those that lose their strength as early as 60 days. There is a dissolution of the threads as a result of exposure to:

1. Enzymes that are present in the tissues of the human body. In other words, these are proteins that control and accelerate the course of chemical reactions.
2. Water. This chemical reaction is called hydrolysis. In this case, the threads are destroyed under the influence of water, which is present in the human body.

Synthetic braided polyglycolide thread "MedPGA"

Analogues of such surgical material are "Safil", "Polysorb", "Vikril".

Self-absorbable sutures after surgery or after childbirth can be applied using the MedPGA thread. This surgical material is made on the basis of polyhydroxyacetic acid. These threads are coated with an absorbable polymer. This is required to reduce wicking and capillarity, as well as to reduce the sawing effect that occurs when the material is passed through tissues.

How long does it take for the MedPGA thread to dissolve?

Self-absorbable sutures applied with the MedPGA thread undergo hydrolytic degradation, which is strictly controlled. It should be noted that such material is quite durable. After 18 days, the threads retain up to 50% of their strength properties.

Complete resorption of the surgical material occurs only after 60-90 days. At the same time, the reaction of body tissues to the MedPHA threads is insignificant.

It should be noted that such surgical material is widely used for suturing all tissues, with the exception of those that are under tension, and also do not heal for a long time. Most often, MedPGA threads are used in thoracic and abdominal surgery, gynecology, urology, plastic surgery and orthopedics. However, it is not used on nervous and cardiovascular tissues.

Synthetic braided polyglycolide thread "MedPGA-R"

Analogues of such surgical material are "Safil Quick", "Vikril Rapid".

"MedPGA-R" is a synthetic thread made on the basis of polyglyclactin-910. Such surgical material is covered with a special absorbable polymer. This reduces friction as the thread passes through the tissues of the body, and also reduces wicking and capillarity. Thanks to this surgical material, self-absorbable sutures can be applied.

How long does it take for MedPGA-R threads to dissolve?

"MedPGA-R" - a material that lends itself to hydrolytic decomposition. Such threads are quite strong. After five days, 50% of their strength properties are retained. Complete resorption occurs only for 40-50 days. It should be noted that the reaction of tissues to the MedPGA-R surgical material is insignificant. In addition, the threads do not cause allergies.

This material is used for suturing mucous membranes, skin, soft tissues, as well as in situations where short-term wound support is needed. However, there are exceptions. Such threads are not used on nervous and cardiovascular tissues.

Synthetic braided polyglycolide thread "MedPGA-910"

Analogues of such surgical material are "Safil", "Polysorb", "Vikril".

"MedPGA-910" is an absorbable thread made on the basis of polygliglactin-910. The surgical material is also treated with a special coating, which reduces the "sawing" effect when the material passes through the tissues, as well as to reduce capillarity and wicking.

Terms of resorption "MedPGA-910"

So, when do self-absorbable sutures applied with the use of MedPGA-910 surgical material dissolve? Such threads have a high rate of strength. However, they also undergo hydrolytic degradation. After 18 days, the surgical material can retain up to 75% of its strength properties, after 21 days - up to 50%, after 30 days - up to 25%, and after 70 days, the threads are completely resorbed.

This product is used for suturing soft tissues that are not under tension, as well as those that heal quickly, in plastic, thoracic and abdominal surgery, gynecology, urology and orthopedics. Do not use "MedPGA-910" when suturing nervous and cardiovascular tissues.

Monofilament "PDO"

There are not so many analogues of such surgical material. This is Biosyn, as well as PDS II. Such threads are characterized by a high rate of biological inertness, are non-wicking and non-capillary, hydrophobic, do not injure tissues when passing through them, are elastic, strong enough, fit well and hold the knot.

How long does it take for monofilaments to dissolve?

Monofilaments "PDO" are amenable to hydrolysis. As a result of this process, dihydroxyethoxyacetic acid is formed, which is completely excreted from the body. 2 weeks after suturing, the surgical material retains up to 75% strength. Complete dissolution of threads occurs within 180-210 days.

As for the field of application, the PDO surgical material is used for suturing and connecting soft tissues of any type, including for suturing the cardiovascular tissues of the child's body, which are subject to further growth. However, there are also exceptions. Monofilaments are not suitable for suturing tissues where wound support is required for up to 6 weeks, as well as those that are subjected to heavy loads. Do not use suture material when installing implants, artificial heart valves, as well as synthetic vascular prostheses.

So how long will the stitches dissolve?

Next, we will consider everything regarding what are self-absorbable sutures after childbirth: when they dissolve, whether they require care. Do not forget that many factors affect the timing of wound healing and the complete disappearance of threads. First of all, you need to know what raw materials the surgical material is made of. In most cases, the threads begin to dissolve 7-14 days after suturing. To speed up the process, after the wound has healed, the health worker may remove the nodules. To determine the timing of resorption of threads, you should check with your doctor:

1. What stitches were placed.
2. What material were the threads made from?
3. Approximate timing of the dissolution of the suture material.

In conclusion

Self-absorbable sutures are often used for suturing surgical wounds that are located in deep tissue layers, as well as on the surface of the skin. For example, organ transplants.

The same surgical material is also used for suturing wounds and ruptures received during childbirth. In the meantime, a lot of research has been done. Their results showed that polyglycolic acid sutures completely disappeared after only four months, while polyglactin-based sutures disappeared after three. At the same time, self-absorbable sutures will hold the edges of the wound until it is completely healed, and then gradually begin to collapse. If the threads persist for a long time and cause discomfort, then you should seek help from a surgeon or your doctor.

It depends on what material they are made of. Most absorbable sutures will begin to dissolve within 1-2 weeks. However, it may take several months for complete resorption. After the postoperative wound has healed, the nurse may remove the remaining ends of the sutures to speed up the process.

Ask your surgeon or treating physician:

• what kind of stitches did you get;
• how much they will dissolve.

What are absorbable sutures?

Stitches are considered absorbable if they lose their strength almost completely within 60 days. Suture threads dissolve under the influence of the following factors:

• enzymes found in body tissues (enzymes are proteins that speed up and control the body's chemical reactions);
• hydrolysis (chemical reaction with water contained in the body).

What material are absorbable sutures made of?

Absorbable sutures are most often made from the following materials:

• polyglactin: loses approximately 25% strength after two weeks, 50% after three, completely absorbed in 3 months;
• polyglycolic acid: loses approximately 40% strength after one week, 95% after four, completely absorbed in 3-4 months.

There are several other types of suture threads. On average, absorbable sutures should begin to fall apart within four weeks. Some materials are completely resorbed after six months.

When are absorbable sutures used?

Absorbable sutures are used for suturing surgical wounds located on the surface of the skin and in deeper layers of tissues. They are usually used to suture surgical wounds deep under the surface of the skin. For example, they can be used during heart surgery or organ transplant.

Absorbable sutures are also used to close wounds on the surface of the skin. For example, they may be used after childbirth to sew up a tear in the perineum (the area of ​​skin between the vagina and anus).

In one study, polyglactin sutures used for perineal ruptures were dissolvable after three months, and polyglycolic acid sutures after four.

Absorbable sutures will connect the edges of the wound until it is completely healed, and then gradually dissolve.

If they continue to cause discomfort after the wound has healed, make an appointment with the surgeon. He will carefully remove the remaining ends of the seams.

What else is used for suturing wounds?

Other methods used in suturing wounds:

• non-absorbable sutures;
• clamps;
• staples.

They should be removed by your doctor when the wound has begun to heal.

• home
• Recovery after childbirth
• Self-absorbable sutures

Self-absorbable threads are often used in surgical interventions, including after childbirth. For applying such sutures, various materials are used that dissolve on their own over a certain time (catgut, lavsan, vicryl).

When are self-absorbable sutures applied?

information Self-absorbable sutures after childbirth are in most cases used for ruptures of the internal genital organs (vagina, cervix), because. access to these organs is difficult and will be easier if it is not required to subsequently remove the stitches there.

With ruptures and cuts of the perineum, various sutures can be applied: both self-absorbable and requiring the removal of threads.

Suture resorption time

Suture resorption time depends on the threads with which it was performed:

1. Catgut. The resorption time depends on the diameter of the thread and the place of its application and ranges from 30 to 120 days;
2. Lavsan. There are threads with different resorption periods (from 10-12 days to 40-50 days);
3. Vicryl(60-90 days).

Complications of postpartum wounds

The main complications of sutures in the postpartum period are the failure (divergence) of the sutures and their suppuration (infection).

Divergence of seams

Failure of internal sutures (on the cervix and in the vagina) is extremely rare. Basically, there is a divergence of the external seams imposed on the perineum.

The main reasons for the divergence of the wound on the perineum:

• Early sitting down;
• abrupt movements;
• sexual life;
• Suture infection.

Signs of divergence of seams:

• Pain in the area of ​​the wound;
• The appearance of bleeding wounds;
• Painful swelling;
• temperature rise(when infected);
• Feeling of heaviness and fullness in the area of ​​the postoperative wound(indicates the accumulation of blood - a hematoma).

wound infection

The penetration of wound infection in most cases occurs when personal hygiene is not followed and improper care of the sutures.

The main signs of purulent-inflammatory complications of sutures on the perineum are:

1. Heat;
2. Hyperemia(redness) of the wound area;
3. soreness;
4. The appearance of purulent discharge from the seams.

At the first sign of complications, you should immediately contact an obstetrician-gynecologist for help. The doctor will carry out the necessary procedures and prescribe treatment.

Stitch care after childbirth

remember The sutures placed on the vagina and cervix do not require additional processing: a woman only needs to follow the rules of personal hygiene to prevent the development of purulent-inflammatory complications. The seams on the perineum, on the contrary, require increased attention and careful observance by the puerperal of all recommendations.

Precautionary measures:

• Should not sit for a week after giving birth(maybe more time limit). A woman is only allowed to lie down and stand. Then you can gradually sit down on a soft surface (pillow) with one buttock, and then as a whole. Do not sit on a hard surface for 3 weeks;
• It is strictly forbidden to use slimming underwear pressing on the perineum;
• On the first day after childbirth, you should strive to delay the act of defecation: a woman should not eat a lot; be sure to avoid products that have a fixing effect;
• Refusal to start sexual activity early. Sex should be started no earlier than 2 months after childbirth.

Seam processing technique:

1. Treatment with an antiseptic solution(mostly brilliant green). In the maternity hospital, the midwife processes the sutures 1-2 times a day on the gynecological chair. At home, a woman should deal with the wound area on her own with the help of relatives or go to an obstetrician-gynecologist at a antenatal clinic every day for a week;
2. Physiotherapy(ultraviolet irradiation of the wound). Continuation of procedures is possible at home with the help of special lamps.

Personal hygiene:

• Change sanitary pads at least every 2 hours;
• Wear only loose underwear made from natural fabrics or special disposable panties;
• 2 times a day to carry out hygiene of the genitals with baby soap, after which thoroughly wipe the perineum with a clean towel and treat with an antiseptic solution;
• Wash with warm water every 2 hours(it is possible to use medicinal herbs - chamomile, calendula);
• Wash your genitals after every visit to the toilet.

Childbirth is not an easy task for a woman. Often in the process of the birth of a baby, a young mother is injured and has to be stitched.

If these are minor tears or cuts in the perineum, cervix, and vagina, doctors often use self-absorbable sutures. They do not require removal by a professional and eventually disappear on their own. But young mothers are very worried about the question of when the threads will dissolve after childbirth and whether it is possible to somehow influence this process.

When are absorbable sutures used?

Self-absorbable sutures are a relatively recent invention. They greatly facilitate the work of surgeons, as they do not require removal. They are especially useful in gynecology. During childbirth, tissues of the cervix, perineum and vagina are often torn. They can also be incised by a doctor to facilitate the passage of the baby and reduce the likelihood of spontaneous rupture, so it is necessary to stitch the tissues.

If the wound is small, it is easier to apply a self-absorbable suture. It is much faster and can often be dispensed with without anesthesia. Its one plus is that a woman does not have to visit the hospital again to remove the stitches, and it is not easy to do this with an infant. In addition, the very process of removing in hard-to-reach places is a rather complicated and painful procedure. Therefore, it is better to do without it.

When the threads dissolve

The terms of resorption of the threads depend on the material from which they are made. Some are absorbed by the enzymes of the human body, while others break down during hydrolysis. Young mothers do not need such complex information, the main thing is to know that four materials are most often used - catgut, maxon, vicryl and lavsan. All of them have their own characteristics:

• Catgut is a natural protein thread that is produced from the intestines of sheep and cattle. They dissolve in about a month, but the first signs of thread destruction can be seen after a week. Thicker threads can last up to four months, but they are not used in gynecology. This is the most popular material for both internal and external sutures after childbirth.
• Vicryl is a synthetic suture often used in surgeries. Completely such threads dissolve in about 60-90 days.
• Maxon is a very strong synthetic thread, which is more often used for suturing tendons, but is also used in gynecology. Complete resorption of the material occurs in 210 days.
• Lavsan - synthetic threads with a variety of resorption periods from 10 to 50 days.

One of the main advantages of self-absorbable suture materials is ease of maintenance. In fact, they do not require any special care measures, it is enough just to strengthen personal hygiene:

• After each trip to the toilet, wash with boiled water or a decoction of medicinal herbs and dry the perineum with a towel;
• Change regularly, after 2-3 hours;
• Treat the seams with antiseptics;
• Wear loose underwear made of breathable fabrics or special postpartum disposable panties.

Increasing pain in the area of ​​​​the seam, bleeding and fever are serious reasons to immediately consult a doctor.

With some types of stitches on the perineum, a woman is not allowed to sit down, she can only stand or lie down. In such situations, it is also important to limit activity and not resume sexual intercourse during the first two months after childbirth. Failure to follow these recommendations may result in seam separation.

It is important to remember that thread resorption and wound healing do not necessarily occur simultaneously. Very often, the seam is already weakening, and the tissues have not yet grown together, so there will be discomfort in the wound area, which will weaken and disappear over time.

A very dangerous sign is the appearance of purulent discharge from the suture. In such a situation, contacting a doctor should be immediate. Infection of the wound threatens with systemic lesions of the body.

How long do self-absorbable sutures take to heal?

It depends on many factors - on the size of the wounds and their shape, on the care of the sutures and, of course, on the characteristics of the body. The regeneration processes are different for all of us, so the speed of wound healing is also different. In most cases, the complete healing of wounds on the organs of the perineum and the resorption of threads takes about a month.

And the sutures after caesarean heal longer, as they affect not only the skin, but also deeper tissues and walls of the uterus. The main thing during this period is not to panic, not to rush things, take care of yourself, take care of the stitches and wait for the body to fully recover.

No matter how accurate 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 of connective (fibrous) tissue. The process of its formation is divided into 4 stages successively replacing each other, and significant internal changes after the fusion of the edges of the wound continue for at least a year, and sometimes much longer - up to 5 years.

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

Stage 1: epithelialization of the skin wound

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

• Immediately after injury, inflammation and swelling occurs. From the adjacent vessels, macrophages - "devourers" come out into the tissue, which absorb damaged cells and clean the edges of the wound. A thrombus is formed - in the future it will become the basis for scarring.
• On the 2-3rd day, 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.

• In parallel, vascular cells begin to divide, forming numerous new capillaries in the damaged area. There are always protective proteins in our blood - antibodies, the main function of which is the fight against foreign agents, so a developed vascular network becomes an additional barrier to a 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 a small effort, they can disperse - even though the incision is already covered with epithelium from above.

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

• Excessive swelling, hematoma, infection, disrupt normal scarring and increase the risk of rough scarring. 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 postoperative wound at this stage is done by a doctor or nurse under his control. You can’t do anything on your own, and it doesn’t make sense to interfere with the natural healing process. 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 in the period 10 - 30 days after the operation:

• Granulation tissue matures. At this time, fibroblasts actively synthesize collagen and elastin, the number of fibers is growing rapidly - hence the name of this phase (the Latin word "fibrilla" means "fiber") - while they are randomly located, 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 scar that forms will always be bright pink. It is easily stretchable and can be injured under excessive loads.

The main danger at this stage is that already fused sutures can 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, medication - many of them are aimed precisely at providing conditions for normal, uncomplicated scarring.

• According to the doctor's prescription, you can start using external creams or ointments to treat the emerging seam. As a rule, these are means that accelerate healing: Actovegin, Bepanten and the like.
• In addition, hardware and physiotherapy procedures aimed at reducing swelling and preventing hypertrophy of fibrous tissue give a good result: Darsonval, electrophoresis, phonophoresis, magnetotherapy, lymphatic drainage, microcurrents, etc.

Stage 3: the formation of a strong scar - "maturation"

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

• If at earlier stages collagen and elastin fibers were arranged randomly, then during the third phase they begin to rebuild, orienting themselves in the direction of the greatest stretching of the incision edges. There are fewer fibroblasts, and the number of vessels also 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, stress or other mechanical stress, the process of collagen restructuring and removal of its excess is disrupted. As a result, the scar can become rough, or even acquire the ability to grow constantly, turning into. In some cases, this is possible even without the influence of external factors - due to the individual characteristics of the organism.

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

• If a tendency to excessive fibrosis becomes apparent, the doctor will prescribe injections that reduce the activity of scarring - usually drugs based on corticosteroids (hydrocortisone or similar). Gives good results or collagenase. In less complex cases, as well as 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 for yourself, just because the appearance of the seam does not meet expectations or does not look like a photo from the Internet, you can significantly disrupt the process of tissue repair, up to their partial atrophy.

Stage 4: final restructuring and formation of a mature scar

Starts 3 months after surgery and lasts at least 1 year:

• The vessels that penetrated the maturing 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 the operation) can the condition and appearance of the scar be assessed, and any corrective measures, if necessary, can be planned.

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 finally formed - otherwise the scarring process may be disturbed due to excessive squeezing of the skin. Therefore, immediately after removing the sutures, the edges of the wound are usually fixed with special plasters. How long to wear them - the surgeon decides, but most often the fixation period coincides with the "average" period of scar formation. With such care, the trace of the surgical incision will be the thinnest and most invisible.
• Another, less well-known, method that is used mainly on the face is. "Switching off" the adjacent facial muscles allows you to avoid the tension of the emerging scar without the use of a patch.
• Aesthetic imperfections of mature scars do not respond well to conservative treatment. If the 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 the mechanical removal of fibrous excess are used: dermabrasion, peeling, and even surgical excision.

Briefly about the most important:

The stage of scar formation and its timing	Main characteristics	Therapeutic and preventive measures
1. Epithelialization 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, as well as trigger the processes of cell division and collagen synthesis.	Careful processing and suturing of the incision (performed by the surgeon). After the sutures are removed, they can be replaced with a plaster to avoid excessive 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 fibrous tissue growth, corrective hardware procedures (microcurrents, lymphatic drainage, etc.)
3. “Maturation” of the scar (starting from the 4th to the 12th week)	Excess connective tissue is gradually absorbed, blood flow weakens. The scar thickens and turns pale - normally it becomes from flesh to white.	The use of non-hormonal ointments for the prevention of rough scarring. With a clear sign of the formation of a keloid - injections or external application of corticosteroids.
4. Final restructuring of tissues (from 13 weeks to 1 year).	Collagen and elastin fibers are aligned along the lines of greatest skin tension. In the absence of complications, a thin whitish strip is formed from a loose, voluminous and elastic cicatricial formation, almost imperceptible from the outside.	Closer to the end of this stage, if necessary, you can apply 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 the person, the slower the damaged tissues grow together - but the more accurate the final result will be. Statistically, gross hypertrophic and keloid scars are more common in patients younger than 30 years of age.
• Heredity. The predisposition to the formation of large, uncontrollably growing scars often runs in families. In addition, people with swarthy and dark skin are more prone to excessive division of connective tissue cells.

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

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