Do I need to remove the stitches for episiotomy?

Episiotomy, whose full name is episiotomy, is a surgery used to prevent perineal tearing and protect the pelvic floor muscles during delivery. Many pregnant women have trouble giving birth because their cervix is ​​not dilated enough, which may cause perineal tear and lead to medical accidents. Therefore, pregnant women who cannot give birth naturally will undergo episiotomy. So, does episiotomy surgery require stitches to be removed?

Does episiotomy require stitch removal?

Whether the episiotomy during normal delivery needs to have its stitches removed depends on whether absorbable or non-absorbable sutures were used at the time. During normal delivery, in order to protect the perineum, a perineal episiotomy is sometimes required to allow the fetus to pass through the perineum smoothly for normal delivery. After the baby is delivered after episiotomy, the wound should be sutured in time to stop bleeding and reduce inflammation. If the intradermal suture is done with absorbable sutures, there is no need to remove the sutures. If the sutures are non-absorbable, they need to be removed. The mother should communicate with the doctor who performed the sutures to see if the stitches need to be removed. Or before giving birth, you can tell your attending physician that you choose absorbable sutures, so that you don't need to remove the sutures after the episiotomy.

1. Absorbable suture

The absorbable catgut used in surgery is a line that can be absorbed by the tissue and therefore does not need to be removed.

Medical gut is divided into ordinary gut and chrome gut, both of which are absorbable. The time required for absorption depends on the thickness of the intestinal thread and the condition of its tissue. It usually takes 6 to 20 days to be completely absorbed. At present, the intestinal threads are all packaged in disposable sterile packaging, which is convenient to use.

(1) Ordinary gut: an easily absorbable suture made from the submucosal tissue of sheep or bovine intestine. It is absorbed quickly, but the tissue reaction to the gut is slightly greater. It is mostly used for ligating blood vessels in tissues or subcutaneous tissues that heal faster and for suturing infected wounds. It is commonly used in mucous membranes such as the uterus and bladder.

(2) Chrome gut: This type of gut is treated with chromic acid, which slows down tissue absorption and causes less inflammatory response than ordinary gut. It is generally used in gynecological and urological surgeries, and is the suture often used in kidney and ureteral surgeries because silk thread can promote the formation of stones. Soak it in saline when using, and straighten it after it softens to facilitate surgical operation.

2. Non-absorbable sutures

That is, the sutures cannot be absorbed by the tissue, so they need to be removed after suturing. The specific time for removing stitches varies depending on the suture site, wound and patient's condition. When the wound heals well and there is no infection or other abnormal condition: remove stitches on the face and neck after 4-5 days; on the lower abdomen and perineum after 6-7 days; on the chest, upper abdomen, back and buttocks after 7-9 days; on the limbs after 10-12 days. The stitches near the joints can be extended a little, and the tension-reducing sutures can be removed after 14 days. In special cases such as malnutrition and high incision tension, the suture removal time may be appropriately extended. The time for stitch removal can be shortened for teenagers, and the time for stitch removal can be delayed for the elderly, diabetics, and those with chronic diseases. If the wound is obviously infected such as redness, swelling, heat, pain, etc. after surgery, the stitches should be removed in advance. Suture removal should be delayed in the following circumstances:

1. Patients with severe anemia, emaciation, and mild cachexia.

2. Those with severe dehydration or water and electrolyte imbalance that has not been corrected.

3. Elderly patients and infants.

4. When coughing is uncontrolled, the suture removal of chest and abdominal incisions should be delayed.