Hysterectomy stump suture

7-10 days after the operation, continuous oozing bleeding occurs, and stump infection is common, usually accompanied by a low-grade fever. In addition to the use of antibiotics, care should be taken to eliminate some necrotic tissue, clean the vagina with 1% iodine disinfectant or ornidazole cotton wool every day, and spray some parts with furacillin or Yunnan Baiyao powder. Prevention: Insufficient preparation of the vagina may cause secretions to remain in the vagina, especially in the corners and folds. Patients with pelvic inflammatory disease or vaginitis before surgery will be given priority anti-infection treatment, and surgery will be resumed after the inflammation is under control. The vagina will be cleaned 3 days before the operation, and the vaginal stump will be disinfected during the operation. For patients from coastal open cities, emphasis should be placed on chlamydia testing before surgery, and targeted treatment should be given if problems are found.

A small amount of bleeding may occur about 10 days after the operation, which is mostly caused by the melting and falling of absorbable sutures. Generally the health bar is not that big, so there is no need to solve it. If there is a lot of bleeding, carefully expand and expose the vaginal stump, and use gauze to block the compression. If active bleeding is seen, electrocautery or surgical suture can be used to stimulate blood circulation. Prevention: After the operation, advise the patient to eat more vegetables and fruits, avoid constipation, and avoid constipation, coughing, squatting, etc. to increase abdominal pressure. Due to the increased abdominal pressure, the supporting force of the pelvic tissue is large, which may affect the healing of the stump and cause the absorbable sutures to fall off.

Bleeding occurs about ten days after the operation, which is mostly caused by non-absorption of absorbable sutures. The sutures can be removed and the area can be sprayed with Yunnan Baiyao powder. If the bleeding is heavy, iodine-form gauze can be used to compress and activate blood circulation. Antibiotics are generally not needed at this time. Chinese medicinal materials such as Callicarpa nudiflora and polyphenol sulfonaldehyde suppositories can be given. Prevention: Pay attention to the quality of sutures. The vaginal mucosa of elderly patients is thin and has poor healing ability, so absorbable sutures are often not absorbed. Estrogen drugs can be added into the vagina before surgery to enhance the resistance of vaginal epithelial cells and promote healing.

Bleeding that occurs about one month after surgery is mostly due to vaginal stump cysts. The bleeding is characterized by irregular bleeding or a small amount of pink discharge in the vagina after defecation. After the cyst is removed, electrocoagulation or 20% silver nitrate can be used to etch the base. Prevention: It has been reported that the use of lember suture can reduce the formation of small granules or bleeding at the stump, indicating that the suture method is also very important. During the operation, the suture line must not pass through the vaginal mucosa. The front, back, left and right walls of the vagina should be sutured with equal short ends and the mucosal surfaces should be immediately matched. In addition, the suture line near the residual end of the vagina should not be too thick, and the remaining thread should not be too long when cutting the thread knot, so as to reduce the formation of cysts.

Treat complications before surgery: For patients with early constipation, chronic bronchitis, severe anemia, hypertension, hypoproteinemia, etc., active treatment should be given before surgery. Anemia can aggravate the ischemic oxygen deficiency of some tissues and affect wound healing. Therefore, patients with anemia need to receive small amounts of fresh whole blood in multiple doses before surgery to ensure that the hemoglobin level reaches at least 8.0g. For diabetics, blood sugar levels should be controlled before surgery. The blood pressure of hypertensive patients decreases during surgery, and there is no bleeding in the cross-section of the vagina. However, the blood pressure rises after the surgery, and some small blood vessels open to the outside, causing bleeding in the vaginal stump. In addition, patients are advised to rest after the operation, not to engage in physical activity too early, and sexual intercourse is strictly prohibited within 3 months.