Diagram of suture layers for cesarean section

Generally speaking, episiotomy is very safe, but it is not necessary for every pregnant woman to do it. The length of the cesarean section incision is determined by the size of the fetus and is generally 10-15 cm. The cesarean section wound is usually below the navel, generally a 15 cm vertical or horizontal wound. But now after cesarean section, the wound is sutured with internal sutures, and the corners of the sutures are not visible on the abdomen. So how many stitches are needed for each layer during a caesarean section?

How many stitches are needed for each layer of cesarean section?

A caesarean section requires seven layers of sutures. After the baby is delivered, the first thing to suture is the uterine myocardium. When suture the uterine myocardium, double layers of sutures are required, followed by the retroperitoneal fold of the bladder, the retroperitoneum, the anterior sheath of the abdominal muscle, fat, and the abdominal cavity. The doctors on the seven floors carefully suture each layer slowly and promote blood circulation, so the uterine sutures and abdominal sutures are very tight. After the cesarean section, there is no need to worry about abdominal wound rupture. As long as there is no infection, you can usually be hospitalized after 5 days. After hospitalization, there will be no significant pain in the abdominal wound.

There is no specific limit to the number of sutures required for a cesarean section. It depends on the length of the incision. Generally, the incision for a cesarean section is about 10 centimeters long and may require six or seven sutures. The sutures for the entire operation are based on the structure of the human body. During cesarean section, after the fetus is delivered and cleared from the uterine cavity, it is time to start suturing. The sutures of the uterus are divided into two layers (muscle layer and serosa layer).

Since the uterus needs to be opened to remove the baby during a caesarean section, the uterus needs to be sutured first and then the abdominal cavity. So from the inside to the outside, they are the uterine muscle layer, uterine serosa layer, retroperitoneum, abdominal muscles, anterior sheath of abdominal muscles, fat layer and skin. If a patient has a history of cesarean section and there are adhesions in the abdomen or pelvis, the anatomical layers will not be very clear during the next surgery, resulting in different degrees of fusion, which is prone to tissue laceration or damage, bleeding, abscesses, etc.

The first thing to pay attention to after cesarean section is vaginal bleeding. If there is continuous and heavy bleeding in the vagina, it is possible to have postpartum hemorrhage and appropriate treatment should be given according to the postpartum hemorrhage. For example, the most common symptom of postpartum hemorrhage is uterine atony, which can be treated by uterine massage, or the use of drugs such as oxytocin, or even intrauterine filling or hysterectomy. After giving birth, the condition of the cesarean section wound should be observed. If swelling, pain, or mass appears in the wound, the wound infection should be cleaned immediately, and antibiotics or even incision and drainage should be performed. Also pay attention to the mammary glands, let the baby suckle in time, for those with insufficient milk supply, give various foods and medicines to promote ovulation and milk production, for those with excessive milk supply, breast pain and lumps, mastitis should be eliminated.

After the fetus and embryo are delivered during the cesarean section, sutures are required step by step. The key sutures are the following multiple layers: the first layer, suture the uterine incision, match the uterine muscle layer, and maintain the consistency of the uterus. The second layer is to suture the retroperitoneum to make the retroperitoneum detailed and smooth. The third layer is suture muscles, which are used to match the separated muscles. The fourth layer is the anterior sheath of suture. The anterior sheath is a more critical layer in the suturing process. The resistance of the wound is mainly carried out by the anterior sheath, so the anterior sheath must be sutured carefully. The fifth layer, suture the fat, and match the fat layers together. The sixth layer, suture the skin, can use silk external suture or absorbable suture intradermal suture, sometimes human fat and skin can be used as a layer of suture.