If the suture on the body has spread after surgery, what should I do in this case? The first thing a person begins to feel, in addition to pain, is a strong panic. We must calm down, because this often happens. First examine the wound, then assess the damage. In most cases, the edges of the resulting damage diverge with the existing infection, so you need to lightly press on the wound and see if there is pus in it. With the help of a flashlight, look inside: what is visible there - the subcutaneous layer or organs inside? When the damage is more than 3 cm, and through it you can see parts of the intestine, as well as other organs, you need to call an ambulance. Pull off the edges of the wound with a band-aid. If the viscera are not visible when the joints are diverged, then you should also go to the operated surgeon or some other similar medical specialist.
So, let's take a closer look at what to do if the seam after the operation diverges, for what reasons this happens. You can also familiarize yourself with preventive measures.
Why does the seam diverge after surgery?
Problems with sutures spreading after surgery are most often encountered after some emergency surgical operations, especially when there was an inflammatory process before, for example, peritonitis due to rupture of the appendix. Other reasons why the suture diverges after surgery include:
- infection in the wound;
- weakness of soft tissue or muscles with the edge of the damage that arose due to some diseases;
- excessive pressure on the area of postoperative sutures, as well as violation or ignoring medical advice;
- stitches too tight after surgery;
- improper technique for suturing a surgical wound;
- injuries in the area of the postoperative suture;
- lack of individual vitamins (for example, vitamin C), trace elements, as well as proteins in the body;
- prolonged use of corticosteroids or taking too high a dosage.
Predisposing factors
There are also a number of factors that determine the predisposition to the possibility that the suture after the operation may diverge:
- diabetes;
- excess weight;
- smoking;
- elderly age;
- the presence of a malignant tumor;
- unbalanced nutrition;
- surgical errors;
- kidney disease
- the implementation of treatment with chemotherapy or radiation therapy;
- in the vicinity of the surgical wound was an old postoperative and traumatic scar;
- ignoring postoperative recommendations regarding physical exertion and weight lifting in the early rehabilitation period;
- excessive pressure directly in the abdominal cavity, which is created due to the accumulation of fluid there, the inflammatory process in the intestine, severe coughing, vomiting, or constipation, can also be dangerous.
Symptoms of seam divergence
The sutures after surgery can spread and before they are removed in the case of the use of suture non-absorbable material. Both one and several signs may appear even when the patient is in the hospital. If the suture has spread after surgery on the abdomen or other area on the body, the following symptoms (or one) will appear:
- sharp pain;
- noticeable edema;
- bleeding;
- hyperemia - when the skin temperature;
- redness;
- the edges of the wound extend from each other;
- visible open wound.
In this case, doctors can fight the problem. Most likely, postoperative sutures will be removed and then replaced with other material. If you are already discharged and are at home, you need to deal with this problem yourself.
Degrees of seam divergence
We figured out if the stitches after the operation can go apart and for what reasons this happens. However, in the field of medicine there is a special term that is used for a divergent surgical wound - eventration. She has four degrees:
- The first degree is characterized by the divergence of all layers on the abdominal wall, with the exception of the skin - subcutaneous eventation.
- The second degree is called partial eversion. In this case, the bottom of the lesions is the stomach, intestines, and also some other internal organs.
- The third degree is called complete eventration, when absolutely all layers on the abdominal wall diverge, and loops of the intestine or omentum approach the edges of the wound.
- The fourth degree is called evisceration or true eventration, in which the internal organs fall out a bit from the wound. As a result, suppuration inside, pinching of the intestine, its partial obstruction may appear.
Diagnosing eventration is quite simple. At the initial stage, on a gauze dry napkin, applied to the damage, the sacral or serous discharge is imprinted. This suggests that the deep layer of the wound has already spread, everything keeps only thanks to the glued skin. Sometimes emphysema can be observed near the wound - the edges in this case are swollen, and during palpation a clear crunch is heard, as if from dry snow or simple starch.
Medical examination
If a suture is opened after surgery, what should I do? Go to the hospital right away. When you come to the specialist, he will examine the general condition of the wound, as well as the surrounding tissues. If necessary, the surgeon will prescribe other studies:
- for infection determination - bacterial inoculation of samples from damage;
- blood analysis;
- X-ray of the postoperative wound to determine the degree of eventation;
- computed tomography or ultrasound to determine the place where purulent contents or sacred discharge has accumulated.
Treatment methods
You can see what the wound looks like if the seam after the operation has been opened, in the photo located above in the text. But how to fix the problem?
The most popular cause of eventation is considered an infection that got into the wound, especially if purulent contents are clearly visible. In this case, the doctor will recommend an antibiotic.
After surgery, the patient may suffer from a decrease in immunity and weakening of the body, therefore, a general strengthening multivitamin agent is usually prescribed.
What to process?
During the acute phase, it is necessary to carefully care for the resulting damage - treat it with antiseptic solutions, as well as powders. This well removes the inflammatory process. Please note that it is not possible to tear off a dry napkin. It must first be moistened in a 3% hydrogen peroxide solution. Then she will move away from the skin. The dressing should be pulled from the periphery of the wound to its center. Next, the wound is treated with the same solution. Pour it a little on the wound and wait until the hydrogen peroxide "hisses". Then clean the wound with a clean bandage and repeat the procedure until the place becomes clean. After this procedure, the wound should be kept open for about 15 minutes. An ideal 3-5 minute irradiation of the wound with an ultraviolet lamp. It removes the infection and also speeds up healing.
The doctor may also advise treatment with a solution of brilliant green, "Fukortsin", "Iodinol", "Iodopyron."
After the procedure, you need to apply a bandage with dimexide, which is diluted with saline in a ratio of 1: 3. As a supplement, a 1% solution of dioxidine is poured onto the compress. If there is suppuration in the wound, the specialist puts a drain or all skin sutures are removed from this area. In the future, it will be delayed by secondary tension. When inflammation subsides, the edges of the damage are allowed to be pulled together with a patch.
Levomekol, ointments with panthenol and sea buckthorn oil are considered excellent wound healing agents. Milk thistle oil fights well with the inflammatory process, improves complete healing and resolves existing scars.
At the stage of scarring, after two months, "Contractubex" or "Mederm" is used.
In more severe concomitant diseases that interfere with wound healing, a permanent or temporary mesh is applied. This prevents damage expansion.
Prevention
Above, we examined why the seams after the operation diverge. But what to do to prevent this? Prevention of joint discrepancy after surgery:
- Sometimes, before surgery, the patient is recommended to undergo antibiotic therapy.
- After the intervention, antibacterial drugs are prescribed. This reduces the possibility of developing postoperative complications.
- People who have not been vaccinated against hepatitis B are advised to be vaccinated a couple of months before the planned surgical operation.
- All doctor's advice should be followed.
- Wear a special postoperative bandage, but not always, so that the wound does not steam.
- When dressing, do not tear off and do not pull the tissue.
- Always keep the dressing clean and free from infection or suppuration.
Conclusion
Can the inner suture spread out after surgery? Yes, that happens. The success of the operation depends not only on a successful intervention, but also on the rapid healing of wounds. The seam requires peace, constant attention and care. If the suture is slightly spread after the operation, you should immediately go to the surgeon who performed the operation. Only he can assess the seriousness of the situation and advise on the right treatment.