How should I care for my stitches?

If you have stitches, take care to:

• keep them clean and dry
• watch out for any increase in redness, swelling or pain

This will reduce your risk of developing an infection, or catch it early.

A doctor or nurse should tell you how to care for your wound. If you are unsure what to do, ask your healthcare team for advice.

Find out more about getting stitches wet.

Protect your stitches

It’s important not to scratch your stitches; even though they’re strong, scratching may damage them.

You should avoid contact sports, such as football or hockey, to give your wound the best possible chance to heal.

You should not go swimming until your wound has healed and your stitches have been removed.

For more information, read How soon can I go swimming after surgery?

If your child has stitches, do not let them play with water, mud, sand and paint.

Playing with things like these could cause the wound area to get dirty or sore, or cause an infection.

Children may also be advised to avoid PE at school until their wound has healed.

Signs of infection

Watch out for any signs of infection near or around the stitches, such as:

• swelling
• increased redness around the wound
• pus or bleeding from the wound
• the wound feeling warm
• an unpleasant smell from the wound
• increasing pain
• a high temperature
• swollen glands

If you have any of these symptoms, speak to a GP or call NHS 111 for advice. You could also visit an NHS walk-in centre or minor injuries unit.

Removing stitches

You will be told if you need to return to a GP or a nurse to have your stitches removed. These are the usual time periods:

• stitches on your head – you’ll need to return after 3 to 5 days
• stitches over joints, such as your knees or elbows – you’ll need to return after 10 to 14 days
• stitches on other parts of your body – you’ll need to return after 7 to 10 days

Some stitches are designed to dissolve gradually and will disappear on their own. Find out how long stitches take to dissolve.

Further information:

Page last reviewed: 6 February 2020
Next review due: 6 February 2023

Suture Wound Care – The Surgery Center at Plano Dermatology

Wound Care Instruction – with Sutures

Download Wound Care Instruction pdf

PRE OPERATIVE INSTRUCTIONS:

• You may continue all medications not listed on the medication sheet. If you have any questions please contact one of our nurses.
• To help you choose the most convenient appointment time, please be aware that you will need to discontinue all activities such as golf, any form of exercise, and yard work until your sutures are removed.
• To ensure the best healing result, we request that you not return to work the day of and the day after your surgery unless otherwise instructed by Dr. Hollabaugh or Dr. Parry. The day of surgery should consist of going directly home, applying ice packs (see below) and rest. Dr.’s Hollabaugh and Parry also request that you do not leave town for at least 48 hours after your surgery.

IF YOU ARE HAVING MOHS SURGERY:

• Because your surgery is performed under local anesthetic, you may eat breakfast that morning.
• Most of our surgeries are performed in a minimum of three hours; however, please plan on being in our office the ENTIRE MORNING.

MATERIALS NEEDED:

1. Hydrogen Peroxide
2. Cotton tipped applicators such as Q-tips
3. Antibiotic ointment – such as Polysporin or Bacitracin.
   PLEASE DO NOT USE NEOSPORIN this contains neomycin which may cause an allergic reaction even if they have used it before without any problems.
4. Non-stick pads – such as telfa, paper tape or any non irritating band aide that will fit over the incision site.

POST OPERATIVE INSTRUCTIONS:

1. Leave the pressure bandage in place for 48 hours. Following the 48 hours the bandage may be removed and begin the following steps twice daily:
2. Clean the wound twice daily with peroxide by using a rolling motion with the Q-tips and then apply a thin layer of ointment over the wound.
3. It is important to keep the wound clean. Dried blood and crusting should be removed to prevent irritation and infection. A layer of polysporin or bacitracin ointment must be kept over the sutures until they are removed. You may leave the incision site covered or uncovered during the day it is your preference, however, we do recommend that a layer of the antibiotic ointment be kept over the sutures at all times. The incision site should be covered at bedtime or if you are outside in a “dusty or dirt” environment. It is also recommended that the site remain covered if the location of the incision is covered by clothing.
4. 48 hours after your surgery you may shower, however, use caution and do not let direct water contact the incision site. After showering, dry the area well and begin wound care as listed above. Do not submerge your suture site in the bathtub, hot tub, pool or lake; this will make your surgical site prone to infection.
5. If an oral antibiotic was prescribed please take it as directed until it is gone.

ADDITIONAL INFORMATION:

1. To help reduce swelling and discomfort after your surgery, ice packs need to be applied over the bandage for 15-20 minutes out of every hour until bedtime. (This is most important for the first 24 hours)
2. For pain management please take Extra Strength Tylenol 1-2 every 4 to 6 hours as needed. If pain medication was prescribed, please take as directed. Do not take any aspirin or ibuprofen products with in 48 hours after your surgery, as this could lead to bleeding.
3. Complications can include excessive bleeding, infection and pain. Some bleeding is normal with in the first 48 hours following surgery. If bleeding should occur, and soaks through your bandage, remain calm and apply steady, firm pressure for 20 minutes. If bleeding persists, contact our office. Signs of infections include: excessive redness, swelling, pain, yellow or green drainage and heat. If any of these symptoms occur, or if you have any questions, please call our direct nurse line at 972-378-0620 x 2109 during office hours.

NOTE: PLEASE DO NOT CHOOSE THE OPTION FOR A SPECIFIC NURSE FROM OUR PHONE PROMPTS. All calls should be directed to your doctor after 4:00.

Dr. Hollabaugh’s cellular phone: 972-814-6809
Dr. Parry’s cellular phone: 972-757-6312.

How to Clean a Surgical Wound in 6 Easy Steps

What is a Surgical Wound?

Simply put, surgical wounds are incisions in the skin made during a medical procedure. All wound care needs are specific to each individual patient, as all surgical wounds are different. They can differ in size, and healing time depending on a variety of factors including age, health, and the type of surgery performed.

Why do Wounds Need to be Cleaned?

Skin is very sensitive during the wound healing process. Because of this, it can sometimes lead to surgical wound incisions reopening. If this happens, make sure to reassure the patient that they should not worry, as this is very common. Breaks can happen in a couple different ways, and can range in severity. However, no matter if a wound opens completely, or just a small part of it, contact a healthcare practitioner for advice. They will decide if further professional action is needed. They also may decide against closing it again, and instead ask the patient and caregiver to clean the wound at home. While open wound care may seem intimidating, it is a completely common, and requires just 6 simple steps.

Did you know? 31% of infections occur post-surgery each year?* With most patients ending up back in the hospital.

*Surgical site infection (SSI) event among healthcare associated infections in hospitalized patients (and then add reference to CDC article attached)

Before getting started, make sure to keep wound care products like gauze sponges & antibiotic ointment(link is external) on hand for future wound maintenance. Follow these six steps for cleaning a wound to aid in the healing process and protect against infection.

How to Clean a Wound in 6 Steps

• Step 1: After hands are washed, remove the old wound dressing from the surgical area, use the wrapper of the gauze to keep it sterile while wetting the new wound dressing with a saline wound wash.
• Step 2: Clean the wound area gently with mild soap and water, antiseptic wash, or saline spray.
• Step 3: Remove any additional dirt with gauze sponges and pat dry.
• Step 4: If there’s any bleeding, stop it by applying pressure to the surgical wound area with the gauze sponges.
• Step 5: Treat with NEOSPORIN^® antibiotic ointment to fight off wound infection for minor wounds. Please consult with a physician before use on a major wound.
  Note: If allergic to NEOSPORIN^®, try POLYSPORIN^® antibiotic ointment(link is external) instead.
• Step 6: Gently cover the clean wound and apply a fresh bandage to the incision area.

If a wound does become infected, learn more information about How to Clean an Infected Wound.

There are a lot of ways for doctors to close a surgical incision after a medical procedure. Whether it’s stitches, staples, or surgical glue; these different methods need different guidelines to care for a wound, depending on which was used to close the incision.

How to Care for Stitches, Staples, & More

What are Stitches?

Stitches are a type of medical thread sewn through the skin at the site of injury that bring the wound together to heal properly.

How to Take Care of Stitches
If a patient has received stitches, the doctor will either remove them after the wound has healed, or they will dissolve over time. If the stiches are dissolvable, medical tape may be used to hold the wound together.

How Long Does It Take For Stitches To Dissolve?
Dissolvable stitches typically begin disintegrating one to two weeks after surgery. Although it is not the norm, be aware that sometimes dissolvable stitches can take up to several months before they disappear completely. After a wound has fully healed, the doctor may suggest speeding up the stitch dissolving process by getting rid of any loose ends from the stitches.

Surgical Staples

What are Surgical Staples?
Surgical staples are a special type of staple used in in medical procedures, instead of stitches, to bring wounds together to heal properly.

How to Care for Surgical Staples:

If a patient has received staples to close the incision, don’t worry about the removal process. As the doctor will schedule time to remove them after the wound has fully healed.

Surgical Skin Glue

What is Surgical Skin Glue?

Surgical skin glue is a special kind of medical skin adhesive often used in surgery. It works by fusing the edges of the wound, and ths allows for the wound to heal underneath the glue. Doctors and nurses often use surgical skin glue to help close wounds instead of other medical closure methods, such as stitches or staples. Skin glue is typically used instead of stitches for some surgical wounds because it is less invasive, and offers the potential for less scarring.

Post-Surgery Wound Care for Surgical Glue
If the doctor used surgical skin glue to close a patient’s wound, the healing process is very simple, as it tends to come off on its own. The timeline for that is usually between five to ten days after surgery.

Need additional wound care information? Call our nurse hotline at 1-800-526-3967 Monday through Friday EST (8am-8pm) to talk to a nurse and discuss additional information about how to care for stitches, staples and more. Or consult with a doctor if there are any additional questions.

Suture Questions

Is this your child’s symptom?

• Sutures or stitches questions
• Stapled wounds are treated the same as sutured wounds
• Skin glue (Dermabond) questions are also covered

When Sutures (Stitches) are Needed for Cuts

• Any cut that is split open or gaping needs sutures.
• Cuts longer than ½ inch (12 mm) usually need sutures.
• On the face, cuts longer than ¼ inch (6 mm) usually need to be seen. They usually need closure with sutures or skin glue.
• Any open wound that may need sutures should be seen as soon as possible. Ideally, they should be checked and closed within 6 hours. Reason: to prevent wound infections. There is no cutoff, however, for treating open wounds.

When Sutures (Stitches) Should be Removed

• Stitches and staples are used to keep wounds together during healing.
• They need to be removed within 4-14 days.
• The specific removal date depends on the location of the stitches or staples.
• Removal should not be delayed. Reason: will leave skin marks.

Wounds That Re-Open After Closure

• Sutures that come out early cause the most concern.
• For open cuts, call your child’s doctor now. General guidelines for re-suturing or re-gluing are listed below:
• Face Cuts. If a face wound has re-opened, call your doctor now. The cut may need to be re-glued or re-stitched. It does not matter how long it’s been since sutures (or glue) were placed.
• Body Cuts and Less Than 48 Hours. If the wound is elsewhere on the body, call your doctor now. The cut may need restitched (or glued) if gaping open. This is sometimes done if suturing was less than 48 hours ago.
• Body Cuts and Over 48 Hours Ago. Call your doctor now for advice. After 48 hours, re-suturing is rarely done (except on the face). After 48 hours, the sutured wound can be reinforced with tape.
• Cut Is Closed, but suture has come out early. The wound should heal up fine without any further treatment. Check with your child’s doctor within the next 24 hours.

When to Call for Suture Questions

Call 911 Now

• Not moving or too weak to stand
• You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

• Stitch (or staple) came out early and wound has opened up
• Wound looks infected (spreading redness, pus)
• Fever occurs
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Suture came out early but wound is still closed
• Suture removal is overdue
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• You have other questions or concerns

Self Care at Home

• Stitched or stapled wound with no other problems

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Sutures

1. Care for a Normal Sutured or Stapled Wound:
   • Keep sutured wounds completely dry for first 24 hours. (4 hours for Dermabond skin glue). If needed, use a sponge bath.
   • After 24 hours, can take brief showers.
   • Avoid swimming, baths or soaking the wound until sutures are removed. Avoid getting Dermabond skin glue wet until it has fallen off. Reason: Water in the wound can interfere with healing.
   • Use an antibiotic ointment (such as Polysporin) 3 times a day. No prescription is needed. Reason: To prevent infection and a thick scab. (Caution: Don’t apply any ointments or creams to Dermabond skin glue.)
   • Cleanse surface with warm water once daily or if becomes dirty.
   • Change wound dressing when wet or dirty.
   • A dressing is no longer needed when edge of wound is closed. This takes about 48 hours. Exception: Dressing is needed to prevent sutures from catching on clothing.
2. Pain Medicine:
   • To help with the pain, give an acetaminophen product (such as Tylenol).
   • Another choice is an ibuprofen product (such as Advil).
   • Use as needed.
3. Suture (or Staple) Removal Date. Here are some guidelines for when sutures (stitches) should be removed:
   • Scalp: 7-10 days (same for staples)
   • Face: 4-5 days
   • Neck: 7 days
   • Chest, abdomen or back: 7-10 days
   • Arms and back of hands: 7 days
   • Legs and top of feet: 10 days
   • Palms, soles, fingers or toes: 12-14 days
   • Overlying a joint: 12-14 days
4. Suture (or Staple) Removal Delays:
   • Don’t miss your appointment for removing sutures.
   • Leaving sutures in too long can leave skin marks. Sometimes, it can cause scarring.
   • It also makes taking the sutures out harder.
5. Suture (or Staple) Out Early:
   • If the sutures come out early, close the wound with tape. You can also use a butterfly bandage (such as Band-Aid).
   • Do this until the office visit.
6. Wound Protection After Sutures (or Staples) Out:
   • Protect the wound from injury during the month after.
   • Avoid sports that could re-injure the wound. If a sport is essential, cover with tape before playing.
   • Allow the scab to fall off on its own. Do not try to pick it off. (Reason: Prevents scarring.)
7. Call Your Doctor If:
   • Starts to looks infected
   • Fever occurs
   • Sutures come out early
   • You think your child needs to be seen
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 05/30/2021

Last Revised: 03/11/2021

Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.

Basic wound management

Author: Suzana Tsao, DO

Editor: Rahul Patwari, MD

Last Updated: 2015

Introduction

Open wounds account for approximately 4.5% of ED visits annually.  Patients seeking Emergency Department treatment for wounds are generally concerned about comesis, infection control, and pain management. Each of these issues needs to be addressed. It is important that ED providers choose the appropriate method of wound closure, taking into account the type of wound, the location, and the risk of infection.

Objectives

1. Describe the key points in the evaluation of a wound.
2. List indications and contraindications for immediate, delayed and non-closure approaches
3. Describe how to appropriately irrigate a wound.
4. Describe how to anesthetize a wound.
5. For the various types of laceration repair (steri-strips, tissue adhesive, staples, sutures) list:
   1. Indications
   2. Contraindications
   3. Technique
6. Describe the size of the suture used for various parts of the body.
7. Describe when sutures should be removed for various parts of the body.
8. Recognize special considerations in wound management (need for antibiotics, when to consult specialist)

Wound Closure Videos

Below are videos created by Dr. Michelle Lin in her Video Instruction of Procedures in the ER (VIPER) series from Academic Life in EM.

Indications

Approaches to wound closure can be grouped into 3 categories: primary closure, delayed  primary closure, and healing by secondary intention.

• Primary Closure: The wound is closed in the acute phase, on the initial presentation to the provider. History and physical should indicate these wounds have low risk for infection, retained foreign body, neurovascular compromise or damage to critical underlying structures.
• Delayed Primary Closure: The wound is irrigated, cleaned, debrided, and bandaged. Repair is scheduled for a later date (approximately 4-6 days). This is often chosen in wounds at high risk of infection. It provides faster and more cosmetically pleasing outcomes than healing by secondary intention.
• Secondary Intention: The wound is allowed to heal spontaneously. Often reserved for dehisced surgical wounds, or wounds presenting very late after the injury occurs. Healing is slower and often leads to significant scarring.

This discussion will concentrate on the various types of primary closure.

History and Physical Exam

The history and physical exam will determine the timing of the wound closure (e.g., primary, secondary, or delayed primary closure), the type of closure (e.g., tape, wound adhesives, staples, or sutures), and the need for consultation (e.g., associated neurovascular injury, underlying fracture, high pressure injuries).

Key historical components:

1. Mechanism of injury
2. Location (both anatomical and environmental)
3. Time of injury
4. Medical history/comorbid conditions (e.g., immunocompromise, diabetes, history of keloid formation)
5. Tetanus immunization status
6. Associated symptoms (e.g., bleeding, numbness, weakness)

Key physical exam components:

1. Location and damage to underlying structures
2. Presence of devitalized tissue
3. Contamination and/or the presence of foreign body
4. Complete neurovascular exam

Wound Irrigation/Preparation

All wounds must be irrigated prior to closure in order to decrease the amount of bacterial contamination and to remove debris.  Traditionally, sterile saline or sterile water has been used to irrigate wounds. Recent studies, however, indicate that wounds irrigated with tap water have a similar rate of infection when compared to sterile solutions: volume of irrigant is the key factor in decreasing decontamination.  Wounds should not be soaked in water or other solutions, as this does not reduce the risk of infection (and may, in fact, increase the risk of infection). A minimum of 250cc of fluid should be used to irrigate the wound or until there is no more visible debris. In general, the more contaminated the wound, the larger amount of solution should be used.

Materials for Irritation

1. 19 gauge angiocath or irrigation shield
2. 20-35cc syringe
3. sterile saline, sterile water, or tap water (at least 250cc)
4. gloves
5. face shield
6. chlorhexadine gluconate or povodine/betadine swabs

Method for Irrigation

1. Draw the water up into syringe and spray it into the wound using the 19 gauge angiocath or irrigation shield.
2. Once the wound is sufficiently cleaned, wipe the surrounding skin with chlorhexadine gluconate or povodine/betadine swabs. Take care not to get these solutions in the wound, as they impair wound healing.

Note: you often need to anesthetize the wound first in order to facilitate thorough cleaning.

Anesthesia

Local anesthesia is typically used prior to placing sutures.  It may also be necessary to anesthetize a wound to facilitate thorough irrigation.  It is important to document a complete neurologic exam of the area prior to anesthesia.  The most common local anesthetics used in the ED are lidocaine, lidocaine with epinephrine, and bupivacaine.

Materials for Anesthesia

1. Anesthetic
2. 18 gauge needle
3. 27 gauge needle
4. 10 cc syringe

Method for Anesthesia

1. Draw up the desired amount of anesthetic with the 18 gauge needle and syringe.
2. Recap the needle and remove it from the syringe.
3. Place the 27 gauge needle on the syringe and remove air from the syringe.
4. Insert the needle through the open wound margin (do not insert through intact skin).
5. Advance the needle along the length of the wound.
6. Aspirate to avoid inadvertent injection of the anesthetic into the vasculature.
7. Inject the anesthetic as you withdraw the syringe from the wound.
8. Repeat this process until the entire margin of the wound is anesthetized.

Use of Different Laceration Repair Agents

Adhesive tapes or steristrips

Indications

1. Low tension
2. Linear
3. Superficial
4. Areas where skin is thin and may not hold sutures (e.g., skin tears in the elderly)

Contraindications

1. High tension wounds (e.g., over joints, gaping wounds)
2. Wounds that require layered closure
3. Wounds in high moisture areas (e.g., axilla/groin)

Technique

1. The wound should be cleaned and prepped as described above.
2. Thoroughly dry the wound.
3. Apply tincture of benzoin (or medical adhesive) to the skin where the tape is to be applied in order to increase adhesion of the tape to the wound.
4. Cut the adhesive tape to the desired length. Leave approximately 2-3 cm on each side of the wound.
5. Remove one strip from the backing and apply to one side of the wound.
6. Gently oppose the two margins of the wound and place the second ½ of the strip over the wound while pressing down on the tape.
7. You may apply extra tape approximately 2-3cm parallel to the wound, over the initial tape to secure it.

You can find a good video demonstrating this procedure on the Laceration Repair website.

Tissue Adhesive (glues)

Indications

1. Low tension
2. Linear
3. Superficial
4. <4cm length

Contraindications

1. High tension wounds (e.g., over joints, gaping wounds)
2. Wounds that require layered closure

Technique

1. The wound should be cleaned and prepped as described above.
2. Thoroughly dry the wound and control bleeding.
3. Using fingers or gauze, approximate the wound margins.
4. Squeeze the adhesive tube so that a small amount of adhesive appears on the applicator tip.
5. Apply a thin layer to the wound.
6. Apply 3 to 4 more layers allowing adhesive to dry between applications.
7. Continue to approximate the wound for 1 minute after final application.
8. Steristrips or adhesive tapes can be used in conjunction with adhesive glues to provide extra strength.

Note: Do not apply antibiotic ointment to the tissue adhesive, as this will dissolve it.  If you need to remove the adhesive, use petroleum based ointment or acetone.

You can find a good video demonstrating this procedure on the Laceration Repair website.

Staples

Indications

1. Scalp lacerations
2. Linear laceration on trunk or extremities where cosmesis is not a priority

Contraindications

1. Gaping wounds requiring layered closure
2. Wounds in areas where cosmesis is a high priority (e.g., face)

Technique

1. The wound should be cleaned and prepped as described above.
2. Consider use of local anesthesia. (sometimes a single staple hurts less than lidocaine injection)
3. Evert the wound margins (may need the help of an assistant) with forceps or fingers.
4. Target the first staple toward the center of the wound, bisecting the wound.
5. Place the arrow on the staple gun in the midline of the wound.
6. Squeeze the handle to insert the first staple.
7. Continue in this fashion, bisecting the remaining parts of the wound.

You can find a good video demonstrating this procedure on the Laceration Repair website.

Sutures

Note: For the purpose of this module, we will only discuss simple interrupted sutures.  More advanced suturing such as layered closure, mattress sutures, and complex wounds can be seen in the video links.

 Indications

1. Clean wounds with little perceived risk of infection
2. Wounds in areas where cosmesis is paramount (e.g., face)
3. Wounds over tendons or nerves which need some type of closure for protection

Contraindications

1. Heavily contaminated wounds
2. Wound with high risk of infection (e.g., puncture wounds, fight bite)
3. Non cosmetic animal bites
4. Wounds with high risk of tissue destruction (high pressure wounds)

Technique

1. The wound should be cleaned, prepped, and anesthetized as described above.
2. Load the needle onto the needle driver at the proximal 1/3 of the needle.
3. Target the first suture in the center of the wound bisecting the wound.
4. With the needle perpendicular to the skin, pierce the skin, and bring it through the center of the wound using an arc-like movement of the wrist.
5. Once a majority of the needle is visible in the center of the wound, unload the needle driver and pick up the needle from the center of the wound (with forceps or the needle driver) and pull it through. Leave approximately one inch of suture material as a tail.
6. Reload your needle as described above using forceps or hemostats, to avoid puncturing yourself with the needle.
7. Bring your needle through the inside of the wound and out the intact skin on the opposite side. Pull the suture material through, being careful not to pull your entire suture out of the wound.
8. Unload needle driver and place needle driver on inside aspect of the suture parallel to the wound. Wrap the long tail of the suture around hemostat twice.
9. Grab the short tail of the suture with the needle driver on the other side of the wound and pull it through. Always wrap the suture around the needle driver towards, not away from the wound.
10. Repeat, this time wrapping the suture only once around needle driver.
11. Repeat this entire process for additional 3-4 throws (i.e., tying knots).
12. Cut the suture leaving a 1-2cm tail to facilitate suture removal.
13. Continue in this fashion, bisecting the remaining parts of the wound until the tissue approximation is satisfactory.

Note:  After a couple of sutures are placed, you may no longer be able to bring the needle through the center of the wound.  In that case you should bring the needle out through the skin on the other side of the wound.

You can find a good video demonstrating this procedure on the Laceration Repair website.

Suture choice and duration

Are antibiotics indicated?

The vast majority of wounds repaired in the ED do not require antibiotics, but can be considered under special circumstances. Antibiotic selection should be directed toward the specific infectious agents you are worried about.

Some examples include:

• Wounds associated with animal or human bites are often contaminated (Pasturella spp and Eikenella corrodens). Consider Amoxicillin/clavulanate.
• Wounds grossly contaminated by dirty water or seawater (ex: oyster cuts). Consider coverage against noncholera vibrio spp (doxycycline) and Aeromonas (Trimethoprim/sulfamethoxazole, amoxicillin/clavulanate and newer fluoroquinolones)
• Wounds with obvious evidence of cellulitis. Cover Staphylococcus and Streptococcus (Trimethoprim/sulfamethoxazole, cephalexin, dicloxicillin, clindamycin) based on local resistance patterns.

Does this wound repair require specialist consultation?

Certain wounds (or wound patterns) should prompt you to consider specialist consultations.

Some examples include:

• Wounds with special cosmetic considerations, such as larger wounds to the face in children (plastic surgery or ENT)
• Wounds that breach the border of the eyelid (ophthalmology)
• Wounds with underlying bone, tendon or joint involvement (orthopedics)
• Wounds to genitals to genitals may require specialized urologic or gynecologic repair. These may also be markers of abuse, necessitating child protection team or other social service evaluations.

Pearls/Pitfalls

• Assess for associated injuries
• Assess for foreign body
• Always check tetanus immunization status and update if needed
• Consider antibiotics vs. delayed primary closure for high risk wound and/or co-morbid conditions
• Don’t dismiss high pressure injuries

References:

1. Centers for Disease Control and Prevention. National Center for Health Statistics. Health Data Interactive. www.cdc.gov/nchs/hdi.htm. [October 2014].
2. Garcia-Gubern CF, Colon-Rolon L, Bond MC. Essential Concepts of Wound Management. Emerg Med Clin N Am. 2010; 28: 951-967
3. Lammers RL, Smith ZE. “Methods of Wound Closure.” Robert and Hedges’ Clinical Procedures in Emergency Medicine.Ed 6. James R. Roberts. Saunders, 2013. 644-690.
4. Lammers RL, Smith ZE. “Principles of Wound Managment.” Robert and Hedges’ Clinical Procedures in Emergency Medicine. Ed 6. James R. Roberts. Saunders, 2013. 611-643.
5. Lloyd JD, Marque III MJ, Kacprowicz RF. Closure Techniques. Emerg Med Clin N Am. 2007; 25: 73-81.
6. http://lacerationrepair.com
7. http://www.aliem.com/videos/

Wound Care

You have a break in the skin. This wound may be because of an injury. Or it may be the result of surgery. Closing the wound helps stop bleeding, protects the wound from infection, and speeds healing. The type of closure that is used depends on the size and location of the wound. Choices include stitches (sutures), strips of surgical tape, skin glue, or staples.

Home care

Your healthcare provider may prescribe medicines for pain. Or he or she may suggest an over-the-counter (OTC) pain reliever, such as ibuprofen. If you have chronic kidney disease, talk with your provider before taking any OTC medicines. Also talk with your provider if you’ve had a stomach ulcer or gastrointestinal bleeding. In certain cases, antibiotics may be prescribed to help prevent infection. If antibiotics are prescribed, take them exactly as directed for as long as directed. Don’t stop taking your antibiotics until they are all gone, even if you feel better.

General care

• Follow the healthcare provider’s instructions on how to care for the wound.

• Wash your hands with soap and warm water before and after caring for the wound. This helps prevent infection.

• If a bandage was applied, change it once a day or as directed. If at any time the bandage becomes wet or dirty, replace it with a new one.

• Unless told otherwise, avoid soaking the wound in water. Take showers or sponge baths instead of tub baths. Don’t scrub or pick at the wound.

• Don’t go swimming.

• If you have a bandage and it gets wet, use a clean cloth to gently pat the wound dry. Then replace the bandage with a dry one.

• Don’t scratch, rub, or pick at the area.

• Watch for the signs of infection listed below. Any wound can get infected, even if you are taking antibiotics. Seek care right away if you see any possible signs of infection.

Care for specific closures

• Stitches. You may want to clean the wound daily after the first 2 to 3 days. To do this, remove the bandage and gently wash the area with soap and warm water. After cleaning, apply a thin layer of antibiotic ointment if recommended. Then apply a new bandage. Stitches es on the outside of the skin usually need to be removed by your healthcare provider.

• Surgical tape. Keep the area dry. If it gets wet, blot it dry with a towel. Surgical tape closures usually fall off within 7 to 10 days. If they have not fallen off after 10 days, you can remove them yourself. To remove the tape, use mineral oil or petroleum jelly on a cotton ball to gently rub the adhesive.

• Skin glue. You may shower or bathe as usual, but don’t use soaps, lotions, or ointments on the wound area. Don’t scrub the wound. After bathing, pat the wound dry with a soft towel. Don’t apply liquids like peroxide, ointments, or creams to the wound while the strips or film is in place. Don’t scratch, rub, or pick at the strips or film. Don’t put tape directly over the strips or film. Skin adhesive film will fall off naturally in 5 to 10 days. If it does not peel off in 10 days, gently rub petroleum jelly or an ointment onto the film.

• Staples. Take showers or sponge baths. Don’t take tub baths. Don’t use lotions on the wound area. The area may be cleaned with soap and water 2 to 3 days after the wound was stapled. Don’t scrub the wound. Pat it dry with a clean soft cloth or towel. You can use antibiotic ointment if your provider tells you to. Staples will need to be removed by your healthcare provider in 10 to 14 days.

Follow-up care

Follow up with your healthcare provider, or as directed. If you have stitches or staples, return for their removal as directed.

When to seek medical advice

Call your healthcare provider right away if you have signs of infection:

• Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

• Increasing pain in the wound

• Increasing redness or swelling

• Pus or bad-smelling drainage from the wound

Also call your provider right away if any of these occur:

How to Care for Dissolvable Stitches

Absorbable sutures, or dissolvable stitches, do not need to be removed. They are made of special materials that can remain in the body for an extended period of time. Over weeks or months, your body dissolves the sutures, well after your incision has closed.

You are probably familiar with standard sutures, also known as stitches. The most common of sutures are the type you may have received when you had a deep cut on your finger or a similar injury. Suture material, a sterile type of thread, is used to literally sew a wound closed.

Those stitches stay in place for a week or two while the wound heals and are then taken out by a nurse or doctor to prevent the sutures from growing into the new, healthy skin that has formed. Absorbable sutures do not have to be removed.

Verywell / Brianna Gilmartin

Uses of Absorbable Sutures

Absorbable sutures are often used internally to close the deepest parts of an incision, but they are also used on the surface of the skin. When a surgeon makes an incision, they are cutting through more than the skin; they are also cutting through the fat that is underneath your skin, and potentially through muscle or other tissues.

Your surgeon may close the deeper parts of the incision with absorbable sutures and then use more sutures on your skin or another type of closure such as adhesive strips or surgical skin glue.

Absorbable sutures vary widely in both strength and how long they will take for your body to reabsorb them. Some types dissolve as quickly as 10 days, while other types can take about six months to dissolve.

The type of suture used depends on your surgeon’s preference, how strong the suture needs to be to properly support the incision, and how quickly your body works to dissolve the material.

Care of Absorbable Sutures

If your absorbable sutures are on your skin, cleaning them is easy. The best way to clean your incision is to clean from the “dirtiest” part of the incision to the “cleanest” part, meaning start at the center of your incision and move out.

You should never scrub your incision. Doing so can be very irritating to the healing skin and can actually slow the closure of your wound.

If you have scabs on your sutures, do not scrub them away. Scabs are a normal part of incision closure and, while they may be annoying, they are a sign that your skin is healing.

Gently washing your incision in the shower, just like you would wash any other part of your body, is considered the best way to care for your incision. Use a gentle soap and water to clean your incision.

Do not use a cream or ointment on your wound unless you have been instructed to do so. Also, avoid bathing and swimming until your incision is fully closed.

Wash external incisions with gentle soap and water. Do not scrub and don’t remove the scabs.

Don’t forget to inspect your incision daily and be sure to look for signs of infection or drainage from your wound.

What to Do If You Can Feel the Sutures

Many people complain that they can feel their absorbable sutures under their incision, even after it appears to have completely healed. First, stop rubbing or poking at your incision site. Your skin may close far faster than the rest of your incision, and repeatedly rubbing your surgical site will not help your healing process.

It is normal to be able to feel internal sutures, and while most absorbable sutures do dissolve within about six months, yours may be gone quicker or they may take far longer to completely dissolve. This is normal and should not be cause for alarm. You may also be feeling scar tissue, rather than sutures, which is also normal for a surgical incision.

Avoid Peroxide

Research has shown that peroxide can reduce the tensile strength of absorbable sutures. In fact, most surgical incisions should not be cleaned with hydrogen peroxide of any strength unless your surgeon specifically tells you to do so.

If you have absorbable sutures, do not clean your incision with hydrogen peroxide.

Peroxide is too harsh for most incisions and can cause irritation, which can lead to infection if you use it near your surgical site. Instead, use water and a mild soap to gently clean your incision or your stitches. Avoid alcohol-based products as well.

A Word From Verywell

Absorbable sutures are common and are very safe, with no need for a follow-up procedure to remove the stitches once the wound has healed. Absorbable sutures aren’t appropriate for every wound but are a good way to close many surgical incisions. 

90,000 Care of the postoperative suture at home. Suture processing after surgery

Hello PAVEL.

The healing process of any surgical suture depends entirely on the level of skin resistance and the whole organism as a whole. In addition, microbial lysis interferes with healing, i.e. infection with pathogenic microorganisms and subsequent suppuration. That is why it is important to know how to properly and effectively care for the seam at home after a laceration associated with a fall.

Suture treatment at home at the initial stage

Today, despite the huge number of antiseptics and drugs that promote the activation of healing and skin regeneration processes, the most effective are ordinary iodine and potassium permanganate. As they say, “cheap and cheerful”!

You should know that it is not enough to process the seam once a day. This must be done at least 2-3 times. Moreover, in the emergency room you should have been warned that it is possible to wet the site of the suture on the wound no earlier than a week after the provision of medical measures.And while taking a shower, and while dressing, and at any other time, you must not touch the seam or exert any mechanical effect on it. This can damage the healing scar on the skin and significantly delay the wound healing process.

Treat the wound until the sutures have healed completely. The first time it is necessary to apply a sterile bandage to the seams. When the wound begins to dry out, the dressing can be removed to allow more oxygen to reach the wound.It is recommended to remove the sterile dressing only if the seam is dry and no pus, blood or other fluid is oozing from the wound. By the way, the release of fluid from the suture is a very common complication in the healing of lacerated wounds, which have been sutured. Such seams are not recommended to be processed at home; a trained specialist should do this. The fact is that the release of fluid from a wound is a sign of infection, therefore, in order to exclude the development of further complications, it is necessary to seek qualified help.

Treatment of the seam consists in gently blotting the seam with a gauze napkin (cotton wool is strongly discouraged, since its particles remaining on the wound can provoke the development of the inflammatory process), abundantly moistened with hydrogen peroxide, and then burn with brilliant green … This is the simplest and most affordable wound care option. In addition to brilliant green, you can treat the wound with alcohol or other antiseptic. Castellani liquid or fucorcin is best suited for this.Also stock up on sea buckthorn ointment, milk thistle oil or Levomekol. The principle of action of these drugs is the same. They promote faster wound healing, and scars look more neat and less noticeable afterwards. Later, when the wound heals, it will be possible to treat with “Panthenol”. It is also quite effective for treating sutures of all types of wounds. If the wound heals well and without complications, it is possible to connect physiotherapeutic procedures as an additional therapy, involving the use of all kinds of absorbable solutions.

Treatment of the scar after suture removal

After the doctor removes the sutures (approximately this happens in the third month), the wound site can be treated with Mederma or Kontraktubes ointments. These are very effective drugs, long-term and regular use of which allows you to almost completely get rid of scar formations on the skin, which appear as a result of tissue damage during injury and subsequent suturing. If the aesthetic moment is of fundamental importance to you, be sure to consult with the doctor who will remove the stitches about the use of these ointments.

Best regards, Natalia.

Discharge from the hospital after surgery implies complete removal of stitches.

In addition, being at home, the patient must properly care for the sutures, using special ointments and creams for early healing of wounds.

In order to prevent negative consequences, it is worth following the recommendations of the observing doctor, if necessary, visit medical facilities for dressing.

Gradually you can move on to self-treatment of wounds under aseptic conditions.

To connect the edges of a lacerated wound after surgery, modern surgeons use the most common method – suture. At the moment, there are two types of them – removable and submerged.

The fixed version is applied using a special material, which subsequently disappears by resorption.

Removable options require removal, which occurs after a certain time.

Consider on what day the postoperative suture is removed:

1. Removable seam is made with natural or synthetic threads and metal parts.

   If the threads are applied correctly, the patient will not have a question: why the suture hurts.

   The threads should be applied in such a way that the tissues heal correctly without squeezing.

2. How are stitches removed? The doctor takes the end of the thread with his hand and pulls it up slightly.

   In the meantime, the threads are shown, which are cut with sterile scissors and the remains are removed with tweezers.

   Let’s answer the question: is it painful to remove the threads? Most likely, the patient will not feel pain if the doctor does it carefully.

3. Withdrawal times usually vary, but the average time set for the overlay period is 6 to 9 days. This indicator may vary depending on the complexity of the operation.
4. To answer the question after how many days the material will be removed, it is necessary to take into account the following factors: part of the body, the nature of the wound, the characteristics of the sick person’s body.

It should be noted that the stitches on the neck and face are removed on days 4-6, on the feet and legs are removed on days 10-12.

This difference is due to different blood circulation in different parts of the body.

How to process at home

Usually, when discharging a patient after surgery, the doctor issues prescriptions for further wound care.

Before processing the seams, consider the effective methods for home use:

1. Potassium permanganate solution – potassium permanganate. This tool can be purchased at a pharmacy, it must be diluted in a sufficient amount of warm water and lubricated with a sutured wound using cotton pads.
2. Iodine – Use this product in moderation to avoid excessive dryness of the epidermis. It is allowed to make a mesh on the wound every 2 days.
3. It is recommended to treat stitches at home with brilliant green – the drug is in every pharmacy.
4. It is allowed to smear the wound with medical alcohol.
5. Use hydrogen peroxide or fucorcin for better healing. The last resort can be inconvenient due to the bright shade.

Anti-inflammatory and healing gels and creams have become most popular in medical practice.How to use them correctly can be found in the next section.

Important! The seams on the abdomen or back can be treated with tea tree oil, larkspur tincture, cream with the addition of calendula.

Before self-treatment of the wound, you must thoroughly wash your hands, disinfect all the instruments used, observe the dosage.

Cream and ointment for wound healing

After discharge from the hospital, as well as after the removal of surgical stitches, it is recommended to use special ointments and creams aimed at wound healing.

Pay attention! Ointment for healing sutures should contain not only medicinal compounds, but herbal ingredients.

Many people ask the question: seroma – what is it? Seroma is the accumulation of serous fluid under the skin after plastic surgery.

Consider a selection of remedies for wound healing:

What to do if the seam is open or festering

To prevent suppuration of the sewn-up site, doctors may install drainage.It is used for 3-4 days.

Doctors install a special tube, the opening of which goes out, and through it an antiseptic is poured.

Consider what to do if the seam has come apart, as well as if it festers:

1. Discrepancy or suppuration can be caused by wound infection, circulatory problems, or trauma to the affected area.
2. If the seam does not heal, use reinforced formulations: Aekol, aloe vera, sea buckthorn oil.
3. If the wound is oozing, use anti-purulent agents – syntomycin ointment, ichthyol ointment, Vishnevsky ointment.
4. When a suture itches, it means it is healing. If the wound has spread, it is necessary to urgently consult a doctor.

After the operation, a fistula may also appear at the site of the wound. It is a neoplasm with pus inside.

Do not joke with postoperative sutures – human health depends on the speed of their healing.

Useful video

Most of the operations performed at the Northwest Center for Endocrinology and Endocrine Surgery are performed on the neck organs – the thyroid gland and the parathyroid glands. With this type of surgery, the skin suture is located in a place that is clearly visible, therefore, the requirements for the cosmetic result of the operation are maximum. We use technologies to reduce the size of the suture (video-assisted surgery) or move the suture to an inconspicuous place (endoscopic surgery from the axillary approach), and at the same time we use proven and effective methods to improve the quality of the postoperative scar.The center’s surgeons believe that the cosmetic outcome of the operation is as important as the clinical outcome.

Over the years of our work, we have tested many different products aimed at improving the cosmetic result. Experiments on animals were also used. Physiotherapeutic procedures were prescribed, gels, creams, plates, dressings and patches were used. The results were carefully evaluated, discarded ineffective means (there were many of them), and eventually came to the methods described below, which have become standard for us, since they have proven their real effectiveness.

Skin adhesive Ethicon Dermabond

During an operation in the Northwest Center for Endocrinology and Endocrine Surgery, a cosmetic suture is applied to the skin with an absorbable suture, after which the surface of the suture is covered with Ethicon Dermabond skin glue (USA). After drying, the adhesive forms a transparent, durable film on the surface of the seam, which protects the seam from moisture and air, ensuring healing under sterile conditions.

The use of glue gives patients a number of important advantages:
– the suture surface is clearly visible to both the patient and the operating surgeon, which makes it possible to quickly assess the state of the operation area;
– no dressings required;
– no need to “remove” the seam, i.e.That is, you do not need to pull out the thread from the skin, which is used for the suture;
– The patient can take water treatments immediately after the operation (we usually recommend starting to take a shower the day after the operation).

The glue remains on the skin surface for 14-20 days, after which it leaves on its own. Already 2 weeks after the operation, the glue can be removed on its own – it does not cause any pain and is done very quickly.

The Endocrine Surgery Center has been using Ethicon Dermabond adhesive for more than 10 years.Skin glue has proven itself well – its use allows you to raise the comfort of the operation to new heights.

The use of skin glue is standard at the Northwest Center for Endocrinology and Endocrine Surgery. The adhesive is applicable to all patients and does not need to be purchased separately.

Silicone plaster “Mepiform”

The second important “secret” that allows you to ensure the optimal cosmetic result of the operation is a silicone patch, specially designed to prevent the development of rough and ugly scars.

The Mepiform patch was developed and manufactured by the Swedish company Mölnlycke Health Care, a world leader in the development of modern high-tech dressings.

The patch protects the postoperative suture from friction and damage, moisturizes the skin surface and provides optimal conditions for healing. When using a silicone patch, the skin suture is much thinner and less visible. The effectiveness of the patch has been proven in a number of clinical trials (Maján J.I et al. Evaluation of a self-adherent soft silicone dressing for the treatment of hypertrophic postoperative scars. Jo WC, Vol15, No 5 (2006), p.193-6 et al.).

Mepiform is easy to use, adheres to the skin by itself, using a layer of soft silicone (Safetac technology). Since the patch is flesh-colored, it is not noticeable on the skin. It is easy to use and does not interfere with your daily activities.

The effectiveness of the “Mepiform” plaster has also been proven by the experience of its use in thousands of patients at the North-West Center of Endocrinology and Endocrine Surgery.At the moment, the recommendation to use this patch is provided to all patients discharged from the center.

Method of application of the “Mepiform” plaster

The most economical is the use of plaster plates 10×18 cm in size.In most cases, 4 plaster plates are sufficient for a full course (only when carrying out lateral cervical lymphadenectomy, when the length of the postoperative suture exceeds 10 cm, the need for a plaster can be up to 6-7 plates).

It is necessary to start using the patch after complete removal of the skin glue. A rectangular section is cut from the patch plate with scissors, the length of which is 1 cm longer than the length of the skin suture, and the width is about 1.5 cm.

Treatment of postoperative sutures at home is a very important procedure that ensures rapid restoration of the dermis.

To speed up the process of wound healing, you need to strictly follow the doctor’s recommendations.

The specialist will prescribe effective drugs for the treatment of the affected areas.

So, how to smear the skin in the area of ​​the seams?

The healing process depends on the human body. In some people, skin regeneration occurs quite quickly, in others it takes a long period of time.

To obtain a good result, it is necessary to provide the postoperative wounds with adequate care
. For this, the doctor selects drugs for the healing of damaged areas.

The following factors affect the speed and characteristics of recovery:

• sterility;
• regularity of procedures;
• materials that are used for processing seams.

One of the key rules for caring for damaged areas of the dermis is to comply with the rules of sterility. Wounds are treated with exceptionally well-washed hands. For this purpose, carefully disinfected instruments must be used.

Depending on the characteristics of the damage, the seams are treated with the following antiseptics:

1. Potassium permanganate solution – it is important to strictly adhere to the dosage. This will help prevent burns.
2. Medical alcohol.
3. Zelenka.
4. Fukarcin – the preparation is wiped off the surface with great difficulty. This can cause discomfort.
5. Hydrogen Peroxide – May cause mild burning sensation.
6. Anti-inflammatory ointments or gels.

In addition, you can treat the wound with an effective antiseptic – Chlorhexidine. In any case, before starting therapy, you should definitely consult a doctor.

To speed up the healing process, it is necessary to follow the algorithm for treating wounds:

• Disinfect hands and devices to be used;
• Carefully remove the bandage from the wound;
• using a gauze swab or cotton swab, apply an antiseptic to the seam;
• Apply a bandage.

Care of the postoperative suture requires compliance with certain conditions:

• processing must be performed 2 times a day, but if necessary, this amount can be increased;
• it is important to systematically check the wound for inflammation;
• to avoid the formation of scars, do not remove dry crusts;
• during water procedures, the use of hard sponges should be avoided
• in the event of complications in the form of redness, swelling or purulent secretions, you should immediately consult a doctor.

Many people are interested in how to process a postoperative suture for better healing. For this purpose, you can use a variety of tools.

Today, you can find many effective topical drugs that can cope with the problem. Their use has a number of advantages:

• availability;
• broad spectrum of action;
• creation of a film on the surface of the wound – this allows you to avoid excessive dryness of tissues;
• dermis nutrition;
• ease of use;
• softening and lightening cicatricial defects.

It is important to take into account that it is forbidden to treat wet wounds with ointments. They are prescribed after the healing process has begun.

Depending on the nature and degree of damage to the dermis, the following types of preparations are used:

• Simple antiseptics – suitable for shallow wounds;
• drugs with hormonal ingredients – used for extensive damage, which are accompanied by complications.

Correctly selected ointment for the healing of postoperative sutures allows you to achieve excellent results.The most effective remedies include the following:

In addition, you can choose an effective ointment or cream for resorption of postoperative sutures. The most effective remedies in this category include the following:

Postoperative suture patch also helps to achieve good results
. This tool is a plate that holds the incision area together and supplies the wound with the necessary substances.

Thanks to the use of a special patch, it is possible to achieve the following results:

• to prevent bacterial microorganisms from entering the wound;
• soak up secretions from the damaged area;
• to provide air flow to the seam area;
• to make the seam softer and smoother;
• to retain the necessary moisture in the scar area;
• to prevent overgrowth of the seam;
• to avoid subsequent damage to the injured area.

All medications must be selected by a doctor
. The specialist will tell you how to care for the affected area.

Any options for self-medication are strictly prohibited, since there is a risk of wound suppuration and progression of inflammation.

To speed up the healing process of the affected areas, you need to use folk recipes. There are quite a few effective remedies today:

To speed up the healing process of postoperative sutures, it is very important to provide good care for the damaged areas of the dermis.For this purpose, drugs and folk remedies are actively used.

Before using any product, it is imperative to consult a doctor. Self-medication can lead to dangerous consequences in the form of severe inflammation.

The healing of the postoperative suture depends on the resistance of the skin itself and the general resistance of the body. Its healing by the type of primary tension is not always possible, which is associated with microbial lysis of the skin flap and suppuration of the secondary suture.

Of the means of processing the postoperative suture, iodine and which have been proven hundreds of times are the most powerful. Thousands of means have been invented more expensive than them, but no more effective!

For a postoperative wound to heal well, patience, hygiene, adherence to the doctor’s recommendations, good rest and good nutrition are necessary.

It is necessary to process the postoperative suture several times a day, especially carefully after taking a shower
. You can wash yourself 7 days after the operation.During washing, do not touch the seam with a washcloth, so as not to damage the healing scar. After the shower, the seam should be blotted with a bandage and treated with hydrogen peroxide. When the scar dries up a little, you need to apply brilliant green directly to the seam.

The suture is processed until it heals completely. If the postoperative suture is dry and nothing oozes out of it, it may not be sealed. Such wounds in the air heal much faster.

Sometimes it can have problem areas. If blood or fluid is oozing from the postoperative scar, the dressing has shifted, or pain appears in the wound area, it is not recommended to process the suture yourself.It is better if it is done by a qualified specialist. The presence of any discharge from the postoperative wound indicates that an infection has entered it, which can spread further, leading to negative consequences. These areas must be treated until the tissue is completely scarred. After removing the threads, the seam is processed for a few more days.

When processing seams, do not use cotton wool. Its particles can remain on the seam and cause inflammation. Therefore, when processing seams, it is necessary to use only gauze napkins.

The wound should be treated with a skin antiseptic – brilliant green, alcohol, iodinol or iodoperone.

Best of all fucorcinum or Castellani liquid – they are great for treating leather. Before caring for the postoperative suture at home, you should stock up on levomekol or sea buckthorn ointment. For healed wounds, ointments that contain panthenol are suitable. Sea buckthorn oil can be replaced with milk thistle oil. Both of these remedies help heal scars and scars, but after being treated with milk thistle oil, the stitches look cleaner.

Ointments “Kontraktubes” and “Mederma” are used for the third month after the sutures were removed.

When caring for a postoperative suture, if there is no discharge from it, you can use physiotherapeutic procedures – phonophoresis with special absorbable solutions. In this case, the seams heal faster and form into subtle scars. Physiotherapy can be started 2-3 weeks after the removal of the stitches.

90,000 How to care for a suture after a cesarean section?

Date of publication: 09.04.2017

Delivering not naturally, but by caesarean section scares many women. Since the procedure is an abdominal operation with a layer-by-layer dissection of the layers of tissue of the abdominal wall from the front. The operation itself is short-lived, but the scar needs proper care after it. First, women in labor are faced with pain and inconvenience, and then, all their lives, an ugly scar reminds them of an operative birth.

Classification of sutures after cesarean

On the soft tissues of the abdominal cavity, as well as on the walls of the uterus, doctors make a not small incision to make it easier to pull the baby out without injuring him.In this case, all layers of tissue are cut, each of which is sutured after operations with specific subtleties.

Layered types of sutures after surgical delivery

• suture on the uterus. The incision in the uterus is sutured with sutures running continuously in one row with a durable synthetic material that is self-absorbing;
• suture on the peritoneum. The serous film covering the internal organs is sutured with a suture absorbable product from the small intestine of sheep (catgut).Catgut sutures are applied in a continuous row;
• seam on the muscles. The muscles that have undergone the incision are also sutured with continuous catgut sutures;
• seams of connective tissues. For suturing the tendon plate (aponeurosis) synthetic absorbent threads are used.

Postoperative sutures are applied at different recesses, due to different incision depths:

1. Internal.
2. Outdoor.

The external section during operative delivery is made in different directions. The differences are due to the specificity of the course of labor:

1. Vertical section. The incision, from the navel to the pubic area, is done with a corporal caesarean section. Doctors make such a decision in the presence of profuse bleeding in a pregnant woman or acute fetal hypoxia. The longitudinal seam increases over the years, becoming thicker.
2. Cross section (Joel-Cohen laparotomy).The incision is made in the transverse direction below the midpoint of the distance between the navel and the pubic area by 3 cm.
3. Arcuate transverse incision (Pfannenstiel laparotomy). In a standard caesarean section, doctors cut the skin on the abdomen laterally along the suprapubic skin fold. The tightening of the incision takes place quickly, leaving behind an almost invisible scar that merges with the suprapubic fold of the skin.

Doctors apply different types of stitches depending on the incision:

• intradermal cosmetic.Such a seam is applied with an arcuate transverse incision. The cosmetic suture is located in the suprapubic fold, it is hardly noticeable and looks aesthetically pleasing;
• interrupted seams. Separate interrupted sutures are made in order to increase the strength of the vertical suture during corporal cutting of the abdomen.

Characteristic of seams

A week after delivery with surgery, a scar forms on the uterus. On the seventh day, the incision heals.

Silk sutures are removed 5-7 days after cesarean section. Cosmetic sutures dissolve on their own after 2-3 months.

A cut on the skin and uterus in the first days after cesarean causes terrible pain. To alleviate the condition of women in labor, doctors inject them with analgesics. And to prevent infection, women take antibiotics.

The nuances of seam care

The suture is treated immediately after application with an antiseptic and a sterile bandage is applied to it.In the maternity hospital, the postoperative suture is monitored by the medical staff, but after discharge, care for him lies entirely on the shoulders of the woman in labor.

How to care for a suture after a cesarean in a maternity hospital?

In the maternity hospital, careful monitoring of wound healing after cesarean is carried out. Nurses for women who have not had their stitches removed change the dressings on a daily basis and treat the stitch with an antiseptic or brilliant green.

To reduce pain, it is recommended to tie up the abdomen with a diaper if there is no postpartum bandage.With a very weeping scar, the dressing is changed more often. Thanks to a good examination in the maternity hospital, the risk of complications, which can manifest itself as increased pain and fever, is avoided.

How to care for a suture after a cesarean at home?

A new mother should look after a scar acquired as a result of a cesarean section at home as well as nurses in a maternity hospital.

After removing the stitches, it can be difficult to heal the wound further.Therefore, women need to know how to properly care for the suture after a cesarean section, after returning home:

the scar is washed regularly with water and treated with disinfectants (salicylic acid, a weak solution of potassium permanganate, brilliant green, iodine, etc.).

the scar during the shower is washed with intimate soap without using a washcloth and wiped dry;

for early healing, the scar is lubricated with special ointments prescribed by a doctor.

In order to avoid complications, in addition to the basic care of the seam, women in labor will have to follow special recommendations:

1. Adhere to good personal hygiene practices regarding hand washing after stool to prevent the growth and spread of bacteria in the rumen.
2. In the first 2 months, do not lift more than 2 kg.
3. Reduce the load on the press.
4. Do not make sudden movements.
5. Wear a postpartum brace.
6. To exclude wearing things that can rub the scar, so it is advisable to wear cotton underwear that is not tight-fitting.
7. Use disposable paper towels to wipe the scar, not terry towels.
8. Do not use a washcloth for a week after removing the stitches.

How to reduce the appearance of a scar after a cesarean?

To make the scar less noticeable and not frighten the mothers themselves, the following is used at home:

• creams and ointments that improve skin recovery;
• ampoules of vitamin E, which accelerates healing and nourishes the skin;
• films and plasters that reduce scars.

Any funds are applied to the formed scar with a healed wound.Laser resurfacing allows you to completely get rid of a defective scar, peeling, plastic and exposure to aluminum particles (microdermabrasion) are less effective.

What should be done in case of complications?

Suture healing for many women in labor can be accompanied by various complications. The following symptoms testify to problems with the scar:

• discharge of pus and blood;
• seam divergence;
• numbness in the area of ​​the scar;
• temperature increase;
• headache;
• long lasting pain in the uterus and scar.

Complications are divided into 2 types:

• early ailments (hematomas, bleeding, suppuration, seam dehiscence). Such problems arise in the postoperative period before suture removal and are detected during dressing change and scar treatment;
• late diseases (ligature fistulas, keloid scar, incisional hernia). These diseases appear in a month or more.

1. Moms and nurses need to be attentive to the scar.If it gets wet consistently, it is washed regularly and bandaged with antiseptic agents. Missing this moment, the seam can fester and lead to inflammation. When pus is released, women in labor are prescribed antibiotics, and the dressing continues to be done with antibacterial ointments. A blood soaked bandage is reported immediately to the doctor, this may be a sign of bruising and bleeding.
2. The divergence of the seams cannot be cured at home; if such a problem is found, they immediately seek qualified help.
3. The roots of painful sensations that follow a woman in labor after a cesarean section for more than a month, redness, induration and swelling of the scar can be ligature fistulas. It is useless to get rid of the fistulas that form as a result of the rejection of suture material by the woman’s body at home with the help of ointments and creams. This defect is removed exclusively by a specialist.
4. Tingling and numbness in the scar area is caused by damage to the nerve endings and will go away on its own when the nerves are restored.The itching of the seam is associated with its healing. Women have to endure this symptom, since it is forbidden to use antipruritics with an unhealed wound. Special ointments that eliminate unpleasant symptoms begin to be used two weeks after the operative delivery.
5. The proliferation of connective tissue that creates a keloid scar is a cosmetic defect. The source of this defect is a hereditary predisposition, not actions to care for the scar.Therefore, women in labor cannot influence the occurrence of an unaesthetic seam. But in any case, women after a cesarean section need to pay attention to the scar that has arisen, not only in the hospital, but also at home for about a year.

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90,000 suture treatment, food, do’s and don’ts

Sterilization of cats is a surgical procedure that involves the removal of reproductive organs, which leads to loss of fertility and cessation of external manifestations of sexual desire.Such a radical procedure is often resorted to by the owners of domestic cats who do not want to bother with her offspring.

Sterilization is carried out by experienced doctors in a veterinary clinic. After such a procedure, the animal must be properly cared for, which will eliminate possible postoperative complications.

In this article, we will tell you about the features of caring for a cat after sterilization, how to process the stitches, when to remove the blanket, how to feed correctly, when you can drink water, after how many days the animal can be washed, why the cat should not jump and what else is unacceptable to do after the operation.

Treatment and protection of the suture after sterilization of the cat

After sterilization, the postoperative suture remains on the cat’s body. It can be on the stomach or on the side if the operation was performed by laparoscopy, which involves punctures. Throughout the entire rehabilitation period, it is important that the seam remains dry and clean.

To protect the postoperative wound from infection and prevent the animal from accessing the unhealed suture after the surgical procedure, the cat is put on a bandage or a special blanket – a fabric bandage with several ties to fix it on the back.

External sutures are applied with a surgical thread, which will need to be removed after about 7-10 days. Until the threads are removed, the owner needs to treat the wound with an antiseptic that does not contain alcohol (it can cause skin burns). Such treatment will reduce the risk of contamination of the seam and penetration of infection into the wound.

Postoperative suture care:

1. The suture area can be treated with Chlorhexidine solution using a conventional pipette to apply to the wound.
2. To accelerate the healing process, the area around the suture can be lubricated with Levomekol ointment.
3. To exclude wound infection, it is recommended to treat the suture area once a day with a special spray – Vetericin, Aluminum or other compounds of a similar effect.

It is better to process the seam after sterilization together with an assistant: one person will hold the cat, the second will carry out the processing procedure, carefully rolling up the blanket.

On the 7-10th day, the sutures are removed in the veterinary clinic.If before this moment the owner notices signs of suppuration, inflammation or bloody discharge in the wound area, the animal must be immediately shown to a doctor! This may indicate the development of postoperative complications that may be associated with wound infection.

When to remove the blanket or bandage

The period of wearing the blanket or bandage is determined individually, depending on the speed of the wound healing process and the cat’s behavior. On average, this accessory is worn for 5-7 days and is removed if there are no signs of wound inflammation.

If sterilization was performed laparoscopically, the period of wearing the bandage can be only 2-3 days. In any case, only an experienced veterinarian can determine the possibility of removing the tissue dressing from the operated animal after a diagnostic examination of the cat, an assessment of the condition of the wound and its well-being.

Cat nutritional regimen after spaying

After spaying a cat, special attention should be paid to its diet and make significant adjustments to its daily menu.Since after this procedure, the metabolic process slows down in the animal’s body and other important changes occur in the work of internal organs, proper nutrition will become an integral part of proper care for your pet.

Rules for feeding the cat after sterilization:

1. In the first days after the operation, the cat should not be given solid food. The stool must be liquid so that during the visit to the toilet there is no divergence of the postoperative sutures.

2. For the first 2-4 days, the pet’s diet is reduced and makes up only one third of the usual dose.

3. On the 4-5th day after the operation, you can gradually increase the portions by 100-150 g per day.

4. Since cats after spaying are prone to obesity, the usual daily food intake should be reduced by 120-130 g.

What and when to feed

anesthesia.If by the evening of the first day after waking up, the animal shows severe hunger, you can give it some low-fat broth from a syringe.

Food for cats after sterilization must be digestible and of high quality. Fatty meats, raw and river fish, fatty dairy products, smoked meats, pickles, legumes, raw eggs, as well as barley, oatmeal and semolina are excluded from the diet.

To prevent urolithiasis and obesity, experts recommend feeding the cat 2-3 times a day in small portions.

Daily ration for an adult cat:

100-120 g of meat;
30-60 g of low-fat dairy products;
30-50 g of vegetables;
10-20 g of cereals.

If symptoms of obesity appear after sterilization, the cat is transferred to fractional nutrition.

If the owner feeds the pet cat with special foods, it is recommended to choose quality premium or super premium formulations. Cheap food contains a lot of salts and heavy minerals that contribute to the development of liver and kidney disease.The assortment of industrial food includes special formulations for neutered cats. They can be used for daily pet feeding, but do not feed such food to the cat in the first days after spaying.

When can you give water

Do not feed or water the animal immediately after surgery. You need to wait for the cat to recover from the anesthesia. Water can be given in a small amount by soldering through a syringe without a needle.

The nuances of postoperative care

The owner needs to ensure proper care of the cat after spaying.And this care includes not only healthy nutrition and postoperative stitches, but also other important procedures that contribute to the rapid recovery of the cat.

Can the cat walk and jump after sterilization

The first day after surgery is the most difficult. The owner needs to be with her at all times. Due to the action of anesthesia, the coordination of movements and the consciousness of the cat are impaired, therefore it is important to monitor its gait and prevent the cat from falling, especially from a height. It is recommended that you prepare your cat’s bed on the floor by laying out a clean towel or blanket.In no case should the cat be placed in places where there are drafts, as well as abrupt movements of the animal should be allowed.

For the first five days after the operation, cats must not jump and play active games. It is recommended to exclude jumping on high surfaces for 10-14 days after sterilization. The owner needs to regularly monitor the behavior of the pet until it is fully restored.

Already on the 6-7th day, the cat can be walked outside, but only under supervision. Walking in the fresh air will benefit your body.

After how many days you can bathe

After the surgical procedure, the cat should not be bathed until the wound has completely healed. The first bath procedure should not be carried out earlier than 14 days after sterilization. For washing a sterilized cat, it is recommended to use special dry shampoos.

If dried blood or ichor remains on the cat’s body after spaying, the owner can gently remove the contamination with Chlorhexidine or hydrogen peroxide.To clean the coat, you can use potato starch, gently rubbed into the animal’s coat.

Do’s and don’ts after surgery

Many owners do not know how to properly care for a cat after spaying, and often make serious mistakes that can cause some harm to the health of the animal. Consider what you can and cannot do after sterilization.

Possible:

1. The owner can gently pick up the cat in his arms, grabbing the front and hind legs at the same time, without pressing or putting pressure on the operated area.
2. Walk the cat outdoors under supervision.
3. Give your cat medications that can relieve pain, but only on the advice of your doctor.

Do not:

1. Taking it in your arms, lift the cat only by the front paws.
2. Treat seams with alcohol-based solutions.
3. Overfeed the animal.
4. Allow the cat to sleep near heaters or on a radiator.
5. Actively play with the cat.
6.Remove the blanket if the wound is not yet healed and the stitches have not been removed.
7. To overfeed the cat.
8. Give her fatty and hard-to-digest foods that cause digestive problems.

After sterilization, an experienced veterinarian will explain to the owner in detail how to properly care for the cat in order to eliminate any risks of postoperative complications. If these rules are observed, the animal will quickly recover from the surgical procedure and will soon return to its usual life!

types, care requirements, removal technology – MC “Harmony”

A suture is the process of joining tissue edges after surgery.

It is necessary in order to prevent infection or foreign body from entering an open wound.

Removal of synthetic sutures and metal staples is performed after the healing of this area, as well as the formation of scars on it.

If absorbable materials (catgut) were used during the operation, there is no need for the procedure.

Types of seams

All seams can be divided into two types:

• internal – seams that are located under the surface of the skin and connect the edges of muscles, organs;
• external – sutures that are applied to the outside of the body and connect the skin.

Any fastening of fabrics has its own term.

The stitches on the head and neck are removed after 5-7 days, the stitches on the limbs – after 8-10 days, the stitches after operations on the internal organs – after 10-14 days.

It should be borne in mind that much depends on the nature of the wound, as well as on the patient’s regenerative abilities.

Complete healing is indicated by the appearance of granules and the alignment of the sutures with the skin color.

Requirements for the care of seams

• regularly inspect and dressings;
• Treat the wound with an antiseptic to avoid inflammation;
• make sure that the edges of the wound are not brought together;
• if suppuration occurs, drink antibiotics;
• if necessary, take care of the presence of a drain.

Suture removal technology

The decision of when this procedure should be performed must be made by the attending physician.

Removal of stitches takes place in several stages:

• the sterile dressing is removed, the surface of the skin is treated with an antiseptic;
• the tip of the thread is pulled with tweezers and cut with scissors in the white area;
• recovered material is removed to a tray for further processing;
• For healing, the damaged area is treated with iodonate solution, a sterile bandage is applied.

Removal of stitches in the center “Harmony”

The Medical Center offers qualified assistance in removing postoperative stitches.

We will make sure that the procedure is painless, in sterile conditions and without any consequences.

Our doctors have the necessary knowledge and experience, and our offices are equipped with professional instruments.

Cost of services

Note

LLC “Harmony” provides discounts in the amount of 10%:

• Veterans
• Pensioners
• Disabled
• Large families
• For healthcare workers

How to take care of yourself after a caesarean section

Childbirth by caesarean section is one of the oldest surgical operations.There are many indications for its implementation, the main purpose of the manipulation is to preserve the health, and sometimes the lives of the mother and baby.

In our reality, a cesarean section is carried out strictly according to indications, and after the operation is completed, doctors continue to closely monitor the woman’s well-being, the recovery processes in her body. Indeed, despite the fact that this operation seems simple enough, and medical technologies are constantly being improved, it is still a surgical intervention.

What exactly and how a woman should watch if she had a cesarean section, Tells Elena Borisovna Machneva , Candidate of Medical Sciences.

Of course, the recovery processes after natural childbirth and after childbirth by caesarean section are different. During childbirth, many changes take place in a woman’s body, for which nature prepared the expectant mother throughout pregnancy. These are various changes in the cardiovascular, endocrine, respiratory systems, blood coagulation system, etc.e. Some of these changes are also activated during cesarean section, and some follow a different scenario.

At the same time, during an operative delivery, a woman’s body is exposed to additional stress and stress due to systemic or local anesthesia, as well as a large wound surface that occurs as a result of abdominal surgery. Therefore, in addition to the general recovery processes, in the postpartum period after cesarean section, there are also processes of recovery of the nervous system after anesthesia, as well as the healing of postoperative sutures.

Since both normal labor and birth by caesarean section are always different for everyone, the recovery period for each individual woman also has individual characteristics. A woman should definitely consult with an obstetrician-gynecologist who delivered or operated on about these features and the protective regime after childbirth.

What determines the process of recovery of the body after a cesarean section?

The recovery process after natural childbirth and after a cesarean section depends on many factors: the characteristics of the course of pregnancy, the characteristics of the initial state of the woman’s health, the presence of chronic diseases in her, the presence of complications in childbirth.The peculiarities of the course of the operation also affect it: an emergency or planned cesarean was done to the woman, what type of anesthesia was used, whether there were any complications during the operation or during the extraction of the fetus, what type of incision was used, and so on. An equally important role is played by the adaptive capabilities of the woman’s body.

Considering all this many factors, it is obvious that there are no two women whose postpartum period would be the same. Therefore, before being discharged from the hospital, every woman needs to ask her doctor in great detail about what regimen should be followed, what physical activity is permissible in her condition, how often it is necessary to see a doctor on an outpatient basis, in what situations it is necessary to see a doctor immediately.

Suture after caesarean section: we follow and care for it correctly

The postoperative sutures after a cesarean section must be treated with great attention, since trouble in this area can lead to serious complications. In the public domain, you can find many tips and tricks on how to care for a postoperative suture, what to do to make it scar faster, what regimen to follow, and even how to treat inflammation in the suture area.

However, experts say: following these general advice is dangerous! In each case, a strictly individual approach is required, and one piece of advice may be appropriate for one woman, but completely unacceptable for another.

For example, even a harmless advice to treat the postoperative suture with brilliant green in the presence of certain problems may be contraindicated due to the risk of missing the incipient inflammation. Therefore, every woman, before leaving the hospital, should clarify the following questions from the doctor in detail: how to care for the seam, how to handle it, how to close it, when to start taking a shower again, whether it is necessary to wear a bandage when showing the seam to the doctor. It is equally important to find out from a specialist what signs should alert and serve as a reason for an immediate doctor’s consultation (itching, seam compaction, pain separated from the seam, bleeding in the seam area, etc.).etc.).

In the future, all recommendations for caring for the suture will be given to a woman by an obstetrician-gynecologist in a antenatal clinic.

A little about the regimen after cesarean section

Have your relatives told you the following: “You need to move more, don’t stay at home, go out for a walk!”? Or vice versa: “Lie in bed, do not move, let everything heal?” It is interesting that the opinions of “experienced” loved ones about what regimen a mother should follow after a cesarean section are diametrically opposite.Whom should you listen to? Of course, your doctor’s supervision.

After all, no matter how many tips about the regime and workload of a woman who underwent a cesarean section, you have not heard, no matter how much you read about it in the blogs of successful mothers and social networks, only the doctor who performed the operation knows the features of its course in this particular woman, and therefore and can give the only competent advice. When, what and how intense the physical activity of his patient should be, the doctor will determine, focusing on the features of the initial state of the woman’s health, the course of pregnancy, the type and course of the operation and the presence of complications.Therefore, it is necessary to talk about the mode and intensity of physical activity only with the doctor before discharge from the hospital and the obstetrician-gynecologist of the antenatal clinic.

You can find on the forums a lot of stories about how mothers “jump” two hours after cesarean, and go out with the baby almost every other day, but the fact remains: we are all different, and only a specialist can determine who which mode is suitable. And the postpartum period is not the time to experiment with your own health.

Checklist: what recommendations a doctor should give after a cesarean section

After being discharged from the hospital, a woman should ask the doctor the following questions:

• How to care for a seam, how to handle it and how to close it;
• when to start taking a shower;
• Do I need to wear a bandage;
• When to show a suture to a doctor.

When you need to see a doctor urgently

What signs should alert and serve as a reason for an immediate doctor’s consultation?

• itching;
• seam sealing;

90,041 pain;

• detachable from the seam;
• bleeding in the seam area

Advice:

If you notice at least one of the following symptoms, consult your specialist immediately!

And any other phenomena that give you anxiety.

When to plan your next pregnancy after a cesarean section?

After a caesarean section, a scar remains on the uterus. In order for this scar to “withstand” the next pregnancy and childbirth, it must be wealthy – that is, contain enough muscle and elastic fibers to withstand the stretching during fetal growth and remain strong enough during labor pains.

The consistency of the scar on the uterus is determined using a specialized examination and occurs in each woman at an individual time.However, in each case, it is imperative that you consult your doctor before planning your next pregnancy.

90,000 how to take care of them to avoid complications

The healing of the postoperative suture depends on the resistance of the skin itself and the general resistance of the body. Its healing by the type of primary tension is not always possible, which is associated with microbial lysis of the skin flap and suppuration of the secondary suture.

Of the means of processing the postoperative suture, iodine and which have been proven hundreds of times are the most powerful. Thousands of means have been invented more expensive than them, but no more effective!

For a postoperative wound to heal well, patience, hygiene, adherence to the doctor’s recommendations, good rest and good nutrition are necessary.

It is necessary to process the postoperative suture several times a day, especially carefully after taking a shower
. You can wash yourself 7 days after the operation.During washing, do not touch the seam with a washcloth, so as not to damage the healing scar. After the shower, the seam should be blotted with a bandage and treated with hydrogen peroxide. When the scar dries up a little, you need to apply brilliant green directly to the seam.

The suture is processed until it heals completely. If the postoperative suture is dry and nothing oozes out of it, it may not be sealed. Such wounds in the air heal much faster.

Sometimes it can have problem areas. If blood or fluid is oozing from the postoperative scar, the dressing has shifted, or pain appears in the wound area, it is not recommended to process the suture yourself.It is better if it is done by a qualified specialist. The presence of any discharge from the postoperative wound indicates that an infection has entered it, which can spread further, leading to negative consequences. These areas must be treated until the tissue is completely scarred. After removing the threads, the seam is processed for a few more days.

When processing seams, do not use cotton wool. Its particles can remain on the seam and cause inflammation. Therefore, when processing seams, it is necessary to use only gauze napkins.

The wound should be treated with a skin antiseptic – brilliant green, alcohol, iodinol or iodoperone.

Best of all fucorcinum or Castellani liquid – they are great for treating leather. Before caring for the postoperative suture at home, you should stock up on levomekol or sea buckthorn ointment. For healed wounds, ointments that contain panthenol are suitable. Sea buckthorn oil can be replaced with milk thistle oil. Both of these remedies help heal scars and scars, but after being treated with milk thistle oil, the stitches look cleaner.

Ointments “Kontraktubes” and “Mederma” are used for the third month after the sutures were removed.

When caring for a postoperative suture, if there is no discharge from it, you can use physiotherapeutic procedures – phonophoresis with special absorbable solutions. In this case, the seams heal faster and form into subtle scars. Physiotherapy can be started 2-3 weeks after the removal of the stitches.

Most of the operations performed at the Northwest Center for Endocrinology and Endocrine Surgery are performed on the neck organs – the thyroid gland and the parathyroid glands.With this type of surgery, the skin suture is located in a place that is clearly visible, therefore, the requirements for the cosmetic result of the operation are maximum. We use technologies to reduce the size of the suture (video-assisted surgery) or move the suture to an inconspicuous place (endoscopic surgery from the axillary approach), and at the same time we use proven and effective methods to improve the quality of the postoperative scar. The center’s surgeons believe that the cosmetic outcome of the operation is as important as the clinical outcome.

Over the years of our work, we have tested many different products aimed at improving the cosmetic result. Experiments on animals were also used. Physiotherapeutic procedures were prescribed, gels, creams, plates, dressings and patches were used. The results were carefully evaluated, discarded ineffective means (there were many of them), and eventually came to the methods described below, which have become standard for us, since they have proven their real effectiveness.

Skin adhesive Ethicon Dermabond

During an operation in the Northwest Center for Endocrinology and Endocrine Surgery, a cosmetic suture is applied to the skin with an absorbable suture, after which the surface of the suture is covered with Ethicon Dermabond skin glue (USA).After drying, the adhesive forms a transparent, durable film on the surface of the seam, which protects the seam from moisture and air, ensuring healing under sterile conditions.

The use of glue gives patients a number of important advantages:
– the suture surface is clearly visible to both the patient and the operating surgeon, which makes it possible to quickly assess the state of the operation area;
– no dressings required;
– no need to “remove” the seam, i.e. you do not need to pull the thread out of the skin with which the suture is applied;
– The patient can take water treatments immediately after the operation (we usually recommend starting to take a shower the day after the operation).

The glue remains on the skin surface for 14-20 days, after which it leaves on its own. Already 2 weeks after the operation, the glue can be removed on its own – it does not cause any pain and is done very quickly.

The Endocrine Surgery Center has been using Ethicon Dermabond adhesive for more than 10 years. Skin glue has proven itself well – its use allows you to raise the comfort of the operation to new heights.

The use of skin glue is standard at the Northwest Center for Endocrinology and Endocrine Surgery. The adhesive is applicable to all patients and does not need to be purchased separately.

Silicone plaster “Mepiform”

The second important “secret” that allows you to ensure the optimal cosmetic result of the operation is a silicone patch, specially designed to prevent the development of rough and ugly scars.

The Mepiform patch was developed and manufactured by the Swedish company Mölnlycke Health Care, a world leader in the development of modern high-tech dressings.

The patch protects the postoperative suture from friction and damage, moisturizes the skin surface and provides optimal conditions for healing. When using a silicone patch, the skin suture is much thinner and less visible. The effectiveness of the patch has been proven in a number of clinical trials (Maján J.I et al. Evaluation of a self-adherent soft silicone dressing for the treatment of hypertrophic postoperative scars. Jo WC, Vol15, No 5 (2006), p.193-6, etc.).

Mepiform is easy to use, adheres to the skin by itself, using a layer of soft silicone (Safetac technology). Since the patch is flesh-colored, it is not noticeable on the skin. It is easy to use and does not interfere with your daily activities.

The effectiveness of the “Mepiform” plaster has also been proven by the experience of its use in thousands of patients at the North-West Center of Endocrinology and Endocrine Surgery. At the moment, the recommendation to use this patch is provided to all patients discharged from the center.

Method of application of the “Mepiform” plaster

The most economical is the use of plaster plates 10×18 cm in size.In most cases, 4 plaster plates are sufficient for a full course (only when carrying out lateral cervical lymphadenectomy, when the length of the postoperative suture exceeds 10 cm, the need for a plaster can be up to 6-7 plates).

It is necessary to start using the patch after complete removal of the skin glue. A rectangular section is cut from the patch plate with scissors, the length of which is 1 cm longer than the length of the skin suture, and the width is about 1.5 cm.

Hello PAVEL.

The healing process of any surgical suture depends entirely on the level of skin resistance and the whole organism as a whole. In addition, microbial lysis interferes with healing, i.e. infection with pathogenic microorganisms and subsequent suppuration. That is why it is important to know how to properly and effectively care for the seam at home after a laceration associated with a fall.

Suture treatment at home at the initial stage

Today, despite the huge number of antiseptics and drugs that promote the activation of healing and skin regeneration processes, the most effective are ordinary iodine and potassium permanganate.As they say, “cheap and cheerful”!

You should know that it is not enough to process the seam once a day. This must be done at least 2-3 times. Moreover, in the emergency room you should have been warned that it is possible to wet the site of the suture on the wound no earlier than a week after the provision of medical measures. And while taking a shower, and while dressing, and at any other time, you must not touch the seam or exert any mechanical effect on it. This can damage the healing scar on the skin and significantly delay the wound healing process.

Treat the wound until the sutures have healed completely. The first time it is necessary to apply a sterile bandage to the seams. When the wound begins to dry out, the dressing can be removed to allow more oxygen to reach the wound. It is recommended to remove the sterile dressing only if the seam is dry and no pus, blood or other fluid is oozing from the wound. By the way, the release of fluid from the suture is a very common complication in the healing of lacerated wounds, which have been sutured.Such seams are not recommended to be processed at home; a trained specialist should do this. The fact is that the release of fluid from a wound is a sign of infection, therefore, in order to exclude the development of further complications, it is necessary to seek qualified help.

Treatment of the seam consists in gently blotting the seam with a gauze napkin (cotton wool is strongly discouraged, since its particles remaining on the wound can provoke the development of the inflammatory process), abundantly moistened with hydrogen peroxide, and then burn with brilliant green …This is the simplest and most affordable wound care option. In addition to brilliant green, you can treat the wound with alcohol or other antiseptic. Castellani liquid or fucorcin is best suited for this. Also stock up on sea buckthorn ointment, milk thistle oil or Levomekol. The principle of action of these drugs is the same. They promote faster wound healing, and scars look more neat and less noticeable afterwards. Later, when the wound heals, it will be possible to treat with “Panthenol”.It is also quite effective for treating sutures of all types of wounds. If the wound heals well and without complications, it is possible to connect physiotherapeutic procedures as an additional therapy, involving the use of all kinds of absorbable solutions.

Treatment of the scar after suture removal

After the doctor removes the sutures (approximately this happens in the third month), the wound site can be treated with Mederma or Kontraktubes ointments. These are very effective drugs, long-term and regular use of which allows you to almost completely get rid of scar formations on the skin, which appear as a result of tissue damage during injury and subsequent suturing.If the aesthetic moment is of fundamental importance to you, be sure to consult with the doctor who will remove the stitches about the use of these ointments.

Best regards, Natalia.

Information on the types and process of postoperative suture healing. And also told what actions should be taken in case of complications.

After a person has survived the operation, scars and sutures remain for a long time. In 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 with a special adhesive
• bloody
  , which are sutured with medical suture material through biological tissues

Depending on the method of suturing bloody, the following types are distinguished:

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

The technique and instruments used for suturing differ:

• manual
  , which are applied using a conventional needle, tweezers and other tools.Suture materials – synthetic, biological, wire, etc.
• mechanical
  , carried out by means of the apparatus using special staples

The depth and extent of the injury dictate the suture method:

• single-row – the seam is applied in one tier
• multilayer – the application is made in several rows (first, muscle and vascular tissues are 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 integumentary tissues)
• submersible
  – not removed (applicable for connecting internal tissues)

Materials that are used for surgical sutures can be:

• Absorbable – no suture removal required.They are usually used for ruptures of mucous and soft tissues
• non-absorbable – removed after a certain period of time established by the doctor

When suturing, 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 suture requires treatment with antiseptic or antibacterial drugs.

How and with what to treat the postoperative suture for better healing at home?

The period of wound healing 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 the correct therapy after suture placement. The following factors affect the timing and nature of healing:

• sterility
• Materials for processing the seam after operation
• regularity

One of the most important requirements for trauma care after surgery is sterility
. Handle 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 observe the dosage to exclude the possibility of burns)
• iodine (in large quantities may cause dry skin)
• with brilliant green
• rubbing alcohol
• with fucarcinom (it is difficult to rub off the surface, which causes some inconvenience)
• hydrogen peroxide (may cause a slight burning sensation)
• anti-inflammatory ointments and gels

Often at home, folk remedies are used for this purpose:

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

Always consult your doctor before using these products. In order for the healing process to take place as soon as possible without complications, it is important to follow the rules for processing sutures:

• Disinfect hands and tools you may need
• carefully remove the bandage from the wound.If it sticks, pour peroxide on

before applying the antiseptic

• Using a cotton swab or gauze swab, lubricate the seam with an antiseptic agent
• Apply bandage

Also, remember to comply with the following conditions:

• process twice a day
  , if necessary and more often
• Carefully examine the wound regularly for inflammation
• To avoid the formation of scars, do not remove dry crusts and scabs from the wound
• Do not rub the seam with hard sponges while showering
• in the event of complications (purulent discharge, edema, redness) consult a doctor immediately

How to remove postoperative stitches at home?

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

We all know that a postoperative suture should be removed by a medical professional in suitable conditions with the help of special instruments.
… 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.

First, prepare the following:

• antiseptic preparations
• sharp scissors (preferably surgical, but you can also use manicure scissors)
• dressing material
• antibiotic ointment (in case of infection in the wound)

Follow the seam removal process as follows:

• Disinfect Instruments
• Wash your hands thoroughly up to the elbows and treat with an antiseptic
• Select a well-lit area
• remove the bandage from the seam
• Using alcohol or peroxide, treat the area around the joint
• Using tweezers, gently lift the first knot
• while holding it, cut the suture thread with scissors
• Carefully, slowly pull the thread
• proceed in the same order and further: lift the knot and pull the threads
• make sure to remove all suture material
• Treat the seam with an antiseptic
• Apply a bandage for better healing

In case of self-removal of postoperative sutures, in order to avoid complications, strictly observe the following requirements:

• Only small surface seams can be removed by yourself
• Do not remove surgical staples or wires at home
• Ensure complete wound healing
• if blood starts flowing during the process, stop the action, treat with an antiseptic and see a doctor
• Protect the seam area from ultraviolet radiation, as the skin there is still too thin and prone 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 seal is observed under the suture in a patient, which was 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 seam area, redness is observed, the temperature may rise
• suppuration
  – with an advanced inflammatory process, pus may discharge from the wound
• formation of keloid scars – not dangerous, however, it has an unaesthetic appearance.These scars can be removed with laser resurfacing or surgery

If you observe the listed symptoms, contact your surgeon. And in the absence of such an opportunity, – to the hospital at the place of residence.

If you see a seal, see a doctor

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

• Observe good hygiene practices. Keep bacteria away from injured area
• Treat the suture twice a day and change the dressing in time
• When taking a shower, avoid getting water on the unhealed area
• Do not lift heavy objects
• Make sure that your clothing does not chafe the seam and areolas around it
• Put on a sterile protective dressing before going outside
• in no case apply compresses and do not rub with various tinctures on the advice of friends.This can lead to complications. The doctor must prescribe the treatment

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

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

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

• swelling and redness in the suture area
• There is a seal under the seam, which can be felt with fingers
• increase in temperature and blood pressure
• general weakness and muscle pain

The causes of the onset 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, as a result of which hematomas were formed
• suture material had increased tissue reactivity
• In overweight patients, wound drainage is insufficient
• low immunity in the operated patient

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

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

If you see reddening of the seam, consult a doctor immediately

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

• weights
  – in obese people, the wound after surgery may heal more slowly
• age – tissue regeneration at a young age occurs faster than
• nutrition – lack of proteins and vitamins slows down the recovery process
• chronic diseases – their presence prevents rapid healing

If you experience redness or inflammation of the postoperative suture, do not postpone your visit to the doctor.It is the specialist who must examine the wound and prescribe the correct treatment:

• removes seams if necessary
• flushes wounds
• will install a drainage system to drain purulent secretions
• will prescribe the necessary drugs for external and internal use

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

• Treat the seam and the area around it several times a day with the drugs prescribed by the attending physician
• During the shower, try not to catch the wound with a washcloth.After leaving the bath, gently blot the seam with a bandage
• Change sterile dressings on time
• Take a multivitamin
• Add extra protein to your diet
• Do not lift heavy objects

In order to minimize the risk of inflammation, it is necessary to take preventive measures before the operation:

• improve immunity
• Sanitize the mouth
• identify the presence of infections in the body and take measures to get rid of them
• Observe strict hygiene rules after surgery

Postoperative fistula: causes and methods of control

One of the 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 the tissues during the operation are called ligatures. Therefore, the fistula, which has arisen due to its rejection, is called ligature. granuloma is formed around the thread
, that is, a seal 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 operation
• Weak patient immune system
  , due to which the body weakly resists infections, and there is a slow recovery after the introduction of a foreign body

Fistulas may 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 seals and bumps near or on the seam
• painful sensations
• discharge of pus
• temperature rise

After the operation, a very unpleasant phenomenon may occur – fistula

If you observe the listed 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:

• Removal of dead tissue around the suture
• washing the wound from pus
• removal of the outer ends of the thread
• patient intake of antibiotics and immunostimulating agents

The surgical method includes a number of medical measures:

• Make an incision for the release of pus
• remove ligutur
• wash the wound
• if necessary, after a few days carry out the procedure again
• in the presence of multiple fistulas, you may be prescribed a complete excision of the suture
• sutures are applied again
• a course of antibiotics and anti-inflammatory drugs is prescribed
• complexes of vitamins and minerals are prescribed
• is the standard therapy prescribed after surgery

Recently, a new method of treating fistulas has appeared – ultrasonic.This is the most gentle method. Its disadvantage is the length of the process. In addition to the listed methods, healers offer folk remedies for the treatment of postoperative fistulas:

• mummy
  Dissolve in water and mix with aloe juice. Soak a bandage in the mixture and apply to the inflamed area. Keep a few hours
• wash the wound with decoction St. John’s wort
  (4 tablespoons of dry leaves per 0.5 liters of boiling water)
• take 100 g of medical tar each
  , butter, flower honey, pine resin, crushed aloe leaf.Mix everything and heat in a water bath. Dilute with rubbing alcohol or vodka. Apply the prepared mixture around the fistula, cover with foil or tape
• for the night on the fistula, apply a leaf of 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 the instruments before the operation
• Avoid contamination of sutures

Ointments for healing and resorption of postoperative sutures

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

• Availability
• Broad Spectrum
• fatty base on the surface of the wound creates a film that prevents tissue overdrying
• skin nutrition
• usability
• softening and lightening scars

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

Based on the nature and depth of skin lesions, various types of ointments are used:

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

• Vishnevsky ointment
  is one of the most affordable and popular pulling aids. Promotes accelerated release from purulent processes
• levomekol
  – has a combined effect: antimicrobial and anti-inflammatory.It is a broad spectrum antibiotic. Recommended for purulent suture discharge
• Vulnuzan
  is a product based on natural ingredients. Apply to both wound and dressing
• levosin
  – kills germs, removes inflammation, promotes healing
• stellanin
  – a new generation ointment that removes puffiness and kills infection, stimulates the regeneration of the skin
• eplan
  is one of the strongest topical treatments.Has analgesic and anti-infectious effect
• Solcoseryl
  – Available as a gel or ointment. The gel is used when the wound is fresh, and the ointment is used when healing has begun. The drug reduces the likelihood of scarring and scarring. Better to put under a bandage
• Actovegin
  is a cheaper analogue of solcoseryl. It 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 antimicrobial and analgesic effect

Joint ointment

• naphthaderm – has anti-inflammatory properties. It also relieves pain and softens scars
• contractubex – used when the suture begins to heal. Has a softening, smoothing effect in the area of ​​scars
• mederma – improves tissue elasticity and lightens scars

The listed remedies 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.

Postoperative suture patch

One of the most effective remedies for the care of postoperative sutures is a plaster made on the basis of medical silicone. It 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 a patch are as follows:

• prevents pathogens from entering the wound
• Absorbs wound secretions
• non-irritating
• breathable, making the skin under the patch breathable
• promotes softening and smoothing of the scar
• retains moisture well in tissues, preventing drying out
• prevents scar enlargement
• easy to use
• when removing the patch, skin injury does not occur

Some patches are waterproof, allowing the patient to shower without risking the seam.The most commonly used plasters are:

• spaceport
• mepilex
• mepitak
• hydrophilm
• retainer

To achieve positive results in the healing of postoperative sutures, this medicine must be used correctly:

• remove the protective film
• , stick the adhesive side to the seam area
• change every other day
• Peel off the patch periodically and check the condition of the wound

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

Video: Postoperative suture processing

Each surgical intervention ends with suturing the surgical incision with special threads. Care of the wound after removing the stitches should be carried out in aseptic conditions with antibacterial ointments, antiseptic agents.

During surgery, the integrity of healthy tissues is disturbed. At the end of the operation, the edges of the abrasion are connected with surgical threads, staples, the care of which must be careful.

There are three types of defect closure:

1. Primary is superimposed upon completion of the operation.
2. Secondary – closed after cleaning the granulating wound.
3. Provisional – applied temporarily, during a surgical intervention, at the end of the operation stage, removed.

Day of stitch removal depends on factors:

• on the type of complexity of the operation;
• postoperative wound length;

90,041 developmental complications;

• on the rate of soft tissue regeneration;
• from leaving.

Stitches are removed on a specific day:

1. After the caesarean section, the staples are removed on day 10.
2. After amputation of limbs, wait 12-14 days.
3. For surgical interventions on the abdominal organs (abdomen), the sutures are opened a week after the operation.
4. The chest is removed after 2 weeks.
5. Regenerative processes on the face are faster. The procedure is carried out in 5-7 days.

Surgical sutures are removed only in the hospital.Carrying out manipulations at home without proper care can result in the development of serious consequences.

Stages and factors in the healing of postoperative sutures

Healing of the wound area is determined by factors:

1. The age of the patient influences the rate of reparative processes.
2. The patient’s weight affects the reparative capacity of soft tissues. The presence of excess fatty tissue prolongs the process of overgrowing of the skin defect.Normally, with proper care, adipose tissue receives a poor blood supply, which slows down the rate of healing. In obese people, there is a high risk of infection in the postoperative area due to the increased susceptibility of lipocytes to pathogenic microorganisms.
3. Hypovitaminosis and poor nutrition reduce metabolism inside damaged tissues. The flow of energy and plastic material into the tissues is disrupted, which negatively affects the reparative functions of the skin.
4. After the operation, the established drinking regime must be observed.Dehydration leads to inadequate flow of fluid into the cells.
5. The vascularized postoperative area heals faster with a constant supply of nutrients.
6. Normal functioning of the immune system contributes to the healing of postoperative wounds without the development of negative consequences. Immunodeficiencies suppress reparative processes inside epithelial cells.
7. Chemotherapy, X-ray irradiation, long-term use of hormonal drugs have a negative effect on the condition of the sutures.
8. Diabetes mellitus disrupts metabolism, leaving can be painful. To increase reparative processes, you need to keep sugar under control, smear the pathological area with special means.
9. Attachment of a bacterial infection reduces the protective function of the skin.
10. The condition of a scratch is negatively affected by hypoxemia, low blood pressure, ischemic damage to injured tissues, cardiovascular diseases.
11. The use of anti-inflammatory drugs in the early stages helps to suppress the reparative functions of the skin and mucous membranes.Application 12-14 days after suture removal has the opposite effect.
12. Insufficient oxygen supply to the tissues slows down the synthesis of collagen, which is involved in wound healing.

They heal in several stages:

1. Microphages react immediately when the integrity of the skin is violated. Fibroblasts migrate to the injured area, which is formed by cut, sutured tissue.
2. Fibroblasts attach to fibrillar structures using fibronectin.The reaction provokes an active synthesis of collagen, the fibers of which close the defect that has arisen.
3. A scar is formed at the site of the wound. Its strength depends on the amount of collagen. Younger patients heal faster than older people.
4. Epithelial cells begin to migrate from the periphery to the central part. The new epithelium acts as a barrier to the penetration of pathogenic microorganisms. Fresh, large scars have poor resistance to infectious agents.Epithelial cells cannot cover the entire postoperative area; careful care is required. Skin transplant is required. The last step in the healing of wound surfaces is to tighten the edges. The skin is restored.

Means for processing seams

Treatment of sutures after removal should be carried out under aseptic conditions with selected preparations. Medicines must be selected according to the type and condition of the wound, its length, the presence of complications, and the type of care for it.Postoperative patients are advised to consult with a doctor about the choice of a drug in order to get the most effective result from treatment in a short time.

The medicinal product must have a regenerative, antiseptic, antimicrobial, reparative effect.

It is better to choose drugs from the group of drying ointments in order to prevent the development of a weeping wound.

For processing, use solutions, creams, gels, powders. The therapy combines several types of care, drugs to achieve an early result.

Solutions

1. Hydrogen peroxide has an antiseptic effect on the damaged area after removal. Upon contact with the skin, active oxygen is released. The solution has a short-term antimicrobial effect. The tool is used 2-3 r / day.
2. When leaving, the treatment is carried out with boric acid. The medicine is applied twice a day.
3. The seams can be wetted. After the water procedure, it is advisable to smear the wound defect daily with brilliant green to reduce the risk of infection.

Ointments, creams, gels

1. Levomekol is a drug with anti-inflammatory, antibacterial effect. Promotes the restoration of the integrity of the skin after removal and discharge. Levomekol is recommended to be applied twice a day.
2. Povidone-iodine promotes healing, prevents the development of inflammation, suppuration. The medicine is applied for half an hour, then washed off with warm water. Careful care with such a medication is not required.
3. Cream Bepanten deals with the normalization of metabolism within tissues. Suppresses the formation, release of pathogenic fluid. The cream is applied 2-3 r / day.
4. Eplan promotes healing of postoperative wounds in a short time. The cream numbes the pathological area, prevents the growth of bacteria inside the postoperative area.

Daily wound care after stitches

After scar removal, it is necessary to continue to care for the postoperative area.Proper care, adherence to the doctor’s recommendations will help to avoid unpleasant complications. Treatment of the wound after removing the stitches should be carried out according to the algorithm:

1. Buy the necessary dressing materials at the pharmacy: bandage, potassium permanganate, brilliant green, hydrogen peroxide, plaster.
2. Carefully inspect the postoperative area prior to treatment. Pathological contents in the form of pus, ichor, blood should not be released.
3. Before handling, wash your hands with soap and water.It is necessary to wash up to the elbow.
4. Disinfect hands with disinfectant.
5. Remove the bandage.
6. The skin around the postoperative scar can be periodically lubricated with brilliant green, iodine.
7. Ointments are applied to the surface of the damaged area, which accelerate the reparative processes.
8. Doctors allow the wound to be wetted after removing the stitches. It is important to lubricate the pathological area with hydrogen peroxide after water procedures. The solution must be applied with a cotton pad or stick.
9. After leaving, the abrasion can be left open or an aseptic dressing can be applied. Secure with a plaster on top.

Possible complications and what to do about it

Common complications in a postoperative wound include:

1. Attachment of a bacterial infection is accompanied by suppuration. A complication arises when the rules of asepsis and antiseptics are not followed when leaving. The abrasion begins to fester. A yellow-brown liquid oozes from it.
2. Skin defect may bloody, weep when dehiscing. An unpleasant situation develops with excessive physical exertion.
3. Seams are parted if removed prematurely. The wound is opened. The procedure should be performed by an experienced surgeon. Otherwise, re-suturing of the skin defect will be required.
4. Inflammation may develop in the postoperative area. The scratch turns red, begins to hurt a lot, bleed. They are treated with anti-inflammatory drugs.
5. Seroma is a common complication after suture removal.The condition is accompanied by transparent secretions without a specific odor. Pathology is associated with the release of intercellular fluid, lymph from the vessels to the outside, poor care for the abrasion.
6. A septic state develops with suppuration of a defect, accession of an infection. Bacteria enter the bloodstream, septicemia develops. The disease can be fatal.
7. Keloid scars cause a cosmetic defect. Many methods of defect removal have been developed.

90,000 Postoperative suture treatment and care with Smith And Nephew patches

A person who has recently undergone surgery is always worried about two problems.The first is that everything is not in vain and the disease recedes. The second is how to properly care for the postoperative suture so that it does not become inflamed, festering and does not turn into an ugly scar.

With regard to solving the first problem, the patient can do little on his own – it all depends on the nature of the disease and the skill of the surgeon. But it is quite possible to ensure the unhindered healing of the surgical suture – especially if you use the Smith And Nephew plasters, which are the subject of further discussion.

Smith And Nephew – what is it?

Smith & Nephew plc is a British company that has been developing and manufacturing medical products for the surgical treatment of joints (including reconstruction procedures), as well as the care of traumatic wounds and postoperative sutures for the second century since 1856.

To solve the last problem, Smith & Nephew specialists have created special bandages, the use of which greatly simplifies the care of surgical incisions and makes it much more effective.

Types of Smith And Nephew plasters

Smith & Nephew produces over 20 types of dressings, but if we talk specifically about the care of sutures after surgery, then four plasters deserve special attention, which you can always buy in the online store https://www.netran.ru/ : Cutiplast, Opsite, Primapore and Leukostrip.

1. Cutiplast. Elastic bandage made of polyester fiber, which provides soft fixation of sutured wounds at any stage of their healing.In the center of the dressing there is a special absorbent pad that absorbs blood and ichor, thanks to which the seam is reliably protected from self-infection due to the decomposition of exudate. The patch is waterproof, which allows patients to shower during the rehabilitation period.

2. Opsite. A group of transparent polyurethane films that allow you to monitor the condition of the seam without changing the dressing. The films are waterproof, which protects the seam from getting wet, and breathable, due to which air enters the wound.There are three types of Opsite films: Flexigrid (for fixing dressings and medical devices), Post-Op (with an absorbent pad to absorb exudate) and Post-Op Visible (the absorbent pad has a cellular structure, without obstructing the visual view of the seam).

3. Primapore. A tissue dressing with an absorbent cushion with high absorbency. It is used to protect wounds with frequent exudation. Very soft and flexible, it can be easily applied to any part of the body, without the risk of subsequent detachment.Primapore patches can get wet in water and should be handled with care when using them.

4. Leukostrip. Bandage-strips made of polyamide fabric, which has elastic properties, and therefore easily adapts to changes in the size of the wound (for example, with postoperative swelling). They are used for sutureless closing of the edges of the surgical suture and preventing its separation, which can lead to the formation of keloid scars. The hypoallergenic adhesive base does not cause irritation and does not injure the skin when the dressing is removed.

How to choose the right patch

The choice of the most optimal bandage is determined by the characteristics of the postoperative suture:

1. No bleeding stitches. In this case, you can protect the wound from contamination and infection with Leukostrip dressings, Opsite Flexigrid or, if there is a possibility of a small exudate release, Opsite Post-Op Visible. This type of bandage is very elastic and can be easily applied to the most difficult parts of the body (knees, elbows, etc.)etc.). But protection from mechanical damage to wounds Leukostrip, Opsite Flexigrid and Post-Op Visible give low, and therefore patients should be careful not to accidentally touch or injure the wound.
2. Exudating sutures (wet). With this type of wound, be sure to use absorbent patches to help keep the seam clean and dry at all times. If there is a significant amount of discharge, it is better to use Primapore dressing, which is specially designed to absorb large amounts of exudate.