Lump near the seam after cesarean. Lump over the seam after cesarean

Many patients are faced with such a problem as suture compaction after cesarean. Pathology can develop under the influence of various reasons. To determine whether a lump on a seam is a danger, a woman should be examined in medical center... Only after that you can select a treatment method. You also need to understand that the problem is not always pathological. In many cases, the seal does not pose a threat to the life and health of the patient.

A cesarean section is performed by cutting the tissue in the abdominal region. The postoperative incision is held together with medical materials. The muscle tissue is sutured with a ligature. On the skin a silk thread is applied. The uterus is held together various materials... The choice of material depends on the type of section and the characteristics of the operation. After cesarean, the recovery period begins. At this time, the stitches should be covered with scar tissue. But the process does not always go smoothly. Some patients complain that the seam after a cesarean section turns red. A lump on the abdomen after a cesarean may appear for the following reasons:

• development of a purulent process;
• tissue infection;
• use of low-quality material;
• postoperative hematoma;
• autoimmune reaction.

A common cause of seam compaction is a purulent process. Suppuration is observed under the influence of various factors. The process is widespread due to improper processing of the postoperative field. Damaged tissue is accompanied by the death of some cells. Dead cells accumulate on the surface of the wound. To enhance healing, the incision is covered with leukocyte cells. The mixing of dead tissue, white blood cells and keratinized skin particles leads to the formation of pus. Pus causes suture inflammation. The tissues begin to thicken.

There is a seal on the seam after cesarean due to infection. Many infections depend on the activity of pathogenic microorganisms. Bacteria can get into the wound during poor-quality surgery or after cesarean with rare treatment. Pathogens multiply rapidly and cause changes in tissue structure. Bacteria feed on tissue cells. An area of ​​tissue affected by pathogenic microbes becomes inflamed. Aggravation of the process is accompanied by compaction. The woman discovers bumps on the wound. Bacterial infection is also determined by additional signs. The patient notices strong burning and itching. A ichor may appear on the surface of the seam. For the doctor to quickly pick up effective treatment, it is necessary to undergo additional examination.

Additional factors

The suture after a cesarean section can be compacted when using low-quality medical material. Consolidation appears due to expired threads. This material causes the seal to form. To get rid of the problem, a second surgery should be performed.

In the first days after a cesarean section, a seal is formed due to a hematoma. Hematoma after cesarean section is frequent problem... The bruise appears due to internal bleeding. The area of ​​the abdominal region where there is a bruise is hard and dense on palpation. This problem in most patients does not require additional intervention. A few days after the surgical intervention, it dissolves.

Autoimmune reactions are rare in women. It is impossible to determine the ailment in advance. Pathology is characterized by the rejection of medical material by the human body.

For unknown reasons, the body perceives the threads as a foreign body. This leads to the appearance of antibodies in the blood. These are special particles designed to capture foreign microorganisms. The autoimmune system's response is unpredictable. This problem can be solved only by selecting a different material or by prescribing a drug to eliminate the activity of the system.

Postoperative fistula formation

Ligature fistulas are a common problem after surgery. Pathology gradually appears in muscle layer abdominal cavity... The problem got its name because of the peculiarities of its appearance. The culprit of the disease is the ligature not completely decomposed. The filaments on the muscle layer should decompose completely within a few weeks after the caesarean section. But under the influence of various negative reasons it doesn't. Part of the ligature is retained in the abdominal region.

The ligature causes inflammation in the damaged tissue. The process is accompanied by the death of cells in the muscle layer surrounding the thread. Dead cells accumulate on the surface of the ligature. The body responds to pathology by producing large numbers of white blood cells. Together with tissue, leukocytes form pus.

Suppuration causes further death of the layers of the abdominal cavity. The problem is not immediately detectable. The woman notices that a small lump appears on the surface of the seams.

The induration is accompanied by the appearance of a slight swelling like a boil. Some time after the operation, a purulent head forms on the upper part of the tumor. The skin is torn. Pus begins to be excreted from the fistulous canal.

Ligature fistula is accompanied by additional symptoms. A woman should pay attention to the following signs:

• throbbing pain in the seam area;
• redness of the skin;
• a feeling of fullness in the area of ​​the scar.

The main symptom of developing internal suppuration is a throbbing pain in the seam area. Pulsating pain occurs due to the gradual death of tissues. You should also pay attention to the feeling of expansion of the scar tissue. It is also triggered by purulent fluid.

The doctor makes the diagnosis after the primary treatment of the fistulous canal. An antiseptic solution is injected into the lumen. Hydrogen peroxide has a good effect. Peroxide breaks down pus and removes it from the canal. After thoroughly cleaning the fistula, the doctor examines the cavity. The remnant of the ligature is found in the muscle layer. You cannot leave material in the channel. He will call further destruction fabrics.

Treatment is carried out through surgery. The doctor removes the remaining threads from the canal. A new suture is not applied to the wound. After the intervention, the woman remains on inpatient treatment... This is necessary to further track the rate of healing. It is also necessary to ensure that a new fistula does not form.

Neoplasm with lymph

A lump over the seam after a cesarean section may form due to the formation lymphatic cavity... This happens against the background of dissection of the lymphatic channels.

All layers of tissue are nourished by the lymphatic system. In a caesarean section, several layers of tissue are cut. The channels are also damaged. After the operation, the tissues are held together with threads. Lymphatic channels and vessel walls remain damaged. In most women, the vessels and canals heal on their own. In some cases, the internal lymphatic canal does not heal. The liquid that moves along the channel enters the free space. A small cavity filled with lymph forms in the peritoneum.

Such a neoplasm is called a seroma. To determine its presence, you need to pay attention to the following signs:

• rounded neoplasm on the skin;
• redness of the skin in the affected area;
• burning sensation.

The main sign of seroma is the formation of a rounded red mass on the skin. In most cases, seroma does not require treatment. She is able to heal on her own. If the seroma persists for a long time, it is necessary to open the surface of the seroma and release the excess lymph. The wound is washed with chlorhexidine solution or sterile liquid furacilin. Gradually, the damage will heal on its own.

Uncharacteristic scar tissue

The suture after a cesarean section can be hardened for other reasons. The surface of the wound after the operation is covered with a thin film that forms a scar. Normal scar tissue should not rise above the skin. Immediately after formation, the tissue is red in color. After a while, the seam brightens and becomes less noticeable to others. But sometimes the scar does not form properly. Under the influence of negative factors, scar cells begin to multiply actively. A keloid scar forms on the wound. The reasons for a keloid scar are as follows:

• transferred infection;
• violation of the update process.

Keloid tissue cannot harm the patient's health. A psychological problem arises. The scar spoils the appearance. Doctors recommend treating a keloid scar using cosmetic techniques.

A hard scar can be removed with a laser. The laser beam has a warming effect on the tissue. It melts. A burn forms on the scar. It is not recommended to remove the scab from the burn yourself. It should disappear completely after a while.

You can resort to sanding. The working surface of the grinder rotates at high speed. Under the influence of friction, the convex part of the scar is gradually eliminated. Several treatments may be required to achieve a good result.

Preventive measures

To avoid problems, you must follow the advice of your doctor. To get a good result, you need to properly postpone the recovery period. The first days after a cesarean section, you must follow the rules for handling the incision. The stitches are processed by the medical staff for several days. The procedure nurse can train the patient to cleanse the wound herself. In order for the stitches to heal correctly, it is necessary to use an antiseptic solution and a drying medicine.

Initially, the seam is washed with an antiseptic liquid. Processing is carried out until complete removal of contaminants. After removing the crust, the edges of the wound should be lubricated with a drying agent. For this purpose, you can use brilliant green or fukortsin. Processing must be carried out at least once a day. This will help prevent infection or inflammation from developing.

It is also necessary to cover the seam surface with a postoperative dressing. Dressings are available at the pharmacy. Manufacturers offer a wide range of dressings from various materials.

After the formation of thin scar tissue, a woman should carefully monitor her health. The following phenomena should cause alarm:

• the appearance of redness around the seam;
• the appearance of blood or ichor from the wound;
• changes in the characteristics of vaginal discharge;
• pain in the incision area.

Redness of the tissues surrounding the seams can be observed due to the development of inflammation or infection of the wound. It is dangerous for the appearance of blood and ichor from the wound a few weeks after the cesarean section. This phenomenon can occur with the initial form of suppuration.

Caesarean section is a difficult and traumatic operation for a woman. After surgery, it is recommended to carefully monitor the characteristics of the suture. If palpation reveals a hard scar, you need to visit a doctor. The specialist will determine the cause of the compaction and select an effective treatment.

Caesarean section often backfires. As with any surgical intervention, it can entail postoperative complications. The most common problem faced by women in childbirth is a hardening of the suture after a cesarean section. For example, induration, redness, purulent formations, inflammation may occur. All this poses a threat to the life and health of a young mother. Many women are worried about an ugly scar that easily spoils even a very beautiful figure. In addition to being unattractive, a scar can also be painful at times.

There are several reasons for the occurrence postoperative complications... The most common of these is infection in the scar. In advanced cases, the inflammatory process can result in sepsis. Some complications can go away on their own without the intervention of doctors. How to understand that it is worth contacting a specialist? What are the causes and types of complications? Details can be found by reading the article further.

Every woman should carefully monitor her health. This is especially true for the appearance of complications after a cesarean section. A seemingly good inner seam can begin to fester six months after surgery for no apparent reason.

The most common causes of complications are:

• getting an infection;
• poor quality ligature;
• unscrupulous surgeon;
• rejection of the ligature by the body.

Infectious contamination usually manifests itself shortly after the operation. It can occur at the time of performing surgical procedures, suturing. With poor-quality performance or insufficient sterility of medical equipment, infection can occur during its subsequent processing. A ligature fistula after a cesarean occurs as a result of the use of poor-quality surgical suture. The process of suturing during such an operation is a very complex process. It is performed in several stages. Performing this work requires real skill from the surgeon. A negligent attitude towards one's own duties can lead to subsequent complications.

Due to individual intolerance, the body itself may begin to reject the ligature. No seals, redness, abscesses should form on the scar. In addition, the scar itself should be flush with the rest of the skin and not appear inflamed. Any of these symptoms can lead to medical attention. It often happens that surgical intervention is required to eliminate the consequences.

It is important! A poorly executed seam can make itself felt after a fairly long time. The scar should be inspected every day during morning or evening dressing. A superficial examination and palpation for the presence of seals is enough.

Timely detection of complications and referral to a doctor for help will minimize Negative consequences operations.

Complications after caesarean section: examples

Some of the negative consequences of a cesarean section do not require treatment and go away on their own. To figure out when to visit a specialist, you need to understand what the main complications that arise after this operation are and whether they require treatment.

Most often, the following consequences appear:

• seroma;
• ligature fistula;
• keloid scar.

Seroma after a cesarean section, it passes without medical intervention. With this complication, a seal appears on the seam, in the form of a small ball, inside which there is lymph. It appears in places where the cut vessels intersect. It is not possible to sew them together. This disease does not require treatment. However, if such symptoms are found, you should visit a doctor to confirm this diagnosis.

Ligature fistula appears only if low-quality lichen was used. An unscrupulous surgeon could have used material with expired suitability, or perform a suture with non-sterile threads, introducing an infection into it. A fistula is a small suppuration located at the seam. In the event of a breakthrough, the lump secretes pus. Periodically, it can become covered with a short-lived crust. The fistula is accompanied by symptoms of fever: an increase in body temperature, chills, weakness. The stomach hurts and shoots in the seam area. A surgeon will be able to help in the treatment of this formation. Suppuration comes from the thread. In order to stop this, you need to remove their tissue from the focus and eliminate the consequences. After completing all the actions, the doctor prescribes special treatment to eliminate the consequences of the fistula.

Note! If there are several fistulas on the suture, the surgeon may decide to remove part of the skin in the scar area as a treatment and apply a new suture.

Keloid scar unlike other complications, it has one problem - an unattractive appearance. The incision site with this complication is significantly compacted. The scar turned red, became very hard. The scar begins to protrude noticeably above the rest of the skin. The seam does not pose a threat to health and therefore does not require treatment. There are several ways to remove this scar: laser removal, surgery, and hormone therapy.

In fact, there can be much more complications after a cesarean section. In order to protect your health, you need to carefully monitor your health and the condition of the seam. It is also fundamentally important to comply with all medical prescriptions regarding postoperative rehabilitation. To prevent infection from entering the scar, it is imperative to follow the rules of personal hygiene, to ensure that only sterile devices and materials are used during the dressings. In case of any changes in the appearance of the seam and its sensations, you should immediately seek help from a surgeon. The doctor will develop an adequate treatment tactics.

Caesarean section is a surgical procedure to remove the fetus from the body of a pregnant woman if it is impossible independent childbirth or for medical reasons.

The operation can be prescribed urgently when labor has already begun, or as planned - before the onset of contractions. Depending on this, the surgeon chooses one of the 2 main types of cesarean section, which differ in the type of incision, the characteristics of the suture and the postoperative period.

There are about 10 methods for performing a cesarean section. If we consider these techniques from the standpoint of the consequences for the mother and the course of postoperative rehabilitation, 2 main methods can be distinguished:

1. In case of an emergency section or certain indications, the doctor performs an isthmicocorporeal laparotomy with a lower midline incision - it opens the skin, subcutaneous fatty tissue, muscles and tendons of the abdominal press, peritoneum and uterus, making a vertical incision from the navel to the pubic region.

In some cases (corporal laparotomy), the incision may continue above the navel. After removing the fetus and placenta, a multilevel suture is applied - first, the walls of the uterus, the peritoneum are sutured, then the tendons and muscle part, subcutaneous tissue and skin. The operation lasts up to 60 minutes, the mother's blood loss is up to 800 ml.

Seam features:

• seam length from 10 cm and more;
• the suture is nodular (not cosmetic), over time it turns into a rather thick and dense scar;
• recovery period 2 months;
• disturbing phenomena in the suture area (pain, coarsening, as well as phenomena requiring qualified intervention) can be observed up to 2 years after the operation;
• to restore the aesthetic appeal of the abdomen, women have to resort to special cosmetic procedures to reduce the seam.

2. With a planned caesarean section, the surgeon performs a Pfannenstiel laparotomy - cuts the skin horizontally in the suprapubic fold (at the level of the bikini line; an incision just above or below this line is used in a similar Joel-Cohen operation), pushes the muscles and bladder apart, makes an incision in the lower part of the uterus and removes the baby.

Then the uterus is sutured, and a continuous intradermal suture is made on the skin. The operation takes 20-40 minutes, blood loss is about 500 ml.

Peculiarities:

• seam length is usually up to 10 cm;
• there is no risk of incisional hernias and muscle defects abdominal wall;
• lower risk of postoperative complications;
• it is allowed to sit down a few hours after the operation, it is recommended to get up no later than in a day;
• the recovery period is about 6 weeks;
• cosmetic scar, small, resolves within 6-8 months.

Care of the seam in the hospital

With the normal course of recovery processes, the treatment of the suture ends with discharge from the maternity hospital. If there are any non-dangerous pathologies, the doctor, upon discharge, will tell you about the peculiarities of caring for the seam at home.

The stationary course of treatment includes 1-2 daily antiseptic blotting and rubbing, and in case of complications - the application of ointments and treatment of the edges of the wound.

Popular drugs used to treat the seam in hospital and at home

The range of medicines for the care of postoperative sutures is quite extensive, however, in hospital practice and in the recommendations of prescribing physicians, there are usually only a few names that are most optimal in terms of therapeutic efficacy and economic benefit.

Vishnevsky ointment

Vishnevsky balsamic liniment is an effective and inexpensive drug for the treatment of festering inflamed wounds closed type... The ointment has not only a pronounced antiseptic effect, but also increases blood circulation in the area of ​​application, contributing to wound healing.

The warming effect, as well as the restriction of oxygen access to the tissues, limits the use of the drug on open and inflamed wounds and in the first 4 days after surgery. You can not use the balm with intolerance to birch tar, castor oil and xeroform.

There are also hypotheses about the possible carcinogenic effect of the components of the drug. But sometimes Vishnevsky's ointment is applied to a sutured, fresh wound after surgery for lack of other means. In hospitals, the balm is applied to the seam with a tampon 2-3 times a day in the first week.

Chlorhexidine

Chlorhexidine bicgluconate 0.05% is an effective and inexpensive modern antiseptic that has replaced the traditional "brilliant green" and its analogues. Chlorhexidine does not cause pain and chemical burns an open wound, has a liquid flowing consistency, therefore it is used to wash and clean not only the adjacent areas, but also the seam itself.

However, sometimes Chlorhexidine causes irritation of the skin, mucous membranes and open tissues of the wound. The action of the drug extends to a fairly wide range of bacterial, viral and fungal agents, as well as protozoa. Chlorhexidine is not addictive in pathogens.

Bepanten

Bepanten, Panthenol and other ointments based on pantothenic acid (vitamin B5) are not antiseptics, but they promote tissue regeneration, so they are recommended to be applied to the suture site for its early healing.

Bepanten has a low antibacterial effect, therefore it is not recommended for use in the first week for processing a suture after a cesarean section

There are variants of the drug with the addition of any antiseptic (Dexpanthenol with chlorhexidine, Bepanten Antiseptic and others).

Zelenka

To treat the skin adjacent to the incision, a solution of brilliant green alcohol 1% is used. The area around the wound 3-4 cm wide is lubricated 2-3 times a day for 2-3 weeks after surgery. In the presence of small bleeding expirations at the time of discharge or when they resume after some time after returning home, treatment continues on an outpatient basis.

Other drugs

Sometimes on the list of prescriptions there are less common suture care medications that show similar, and sometimes even more, effectiveness.

Home care

Suture processing and monitoring activities continue after discharge from the hospital and include several important points that must be observed despite the mother's workload with household chores and childcare.

Guard mode

A woman who has undergone a caesarean section should not lift weights over 3 kg, bend and squat for a month. It is necessary to abstain from sexual activity for at least 2 months.

Lactation

Seam processing

A seam after a cesarean section at home is needed daily
process with the funds recommended at discharge until the end of the expiration of the ichor (usually up to 2 weeks).

Diet

To prevent suture divergence and support immunity, which is responsible for the fight against possible infections, it is necessary to follow a postoperative diet. The well-established work of the gastrointestinal tract after surgical obstetrics protects the woman's body from intoxication with fermentation and decay products.

A special diet is designed to reduce the risk of intestinal paresis and intestinal obstruction.

After daily postoperative fasting, patients are allowed light broths and unsweetened yoghurts. After the first discharge of gases and within a month, boiled, baked, stewed and steamed dishes from lean meat and vegetables, buckwheat, oatmeal, millet and pearl barley porridge are offered.

A week after the section, a little raw fruits and vegetables of green and white color are introduced into the diet - sources of vitamins, minerals and fiber. In addition, cereals, wholemeal bread, fruits, vegetables, vegetable oils and prunes regulate intestinal motility well. Fermented milk products are indispensable for the restoration of intestinal microflora.

For the first 3 months, fast food, smoked meats, canned food, pickled foods, mushrooms, buns, chocolate, fried and fatty foods are excluded from the diet; in order not to provoke constipation, it is advisable to refrain from rice and potatoes. Food should be consumed in fractional portions 5-6 times a day and drink plenty of water. In the future, the diet is regulated by the needs of the baby during breastfeeding.

Bandage

After an operative delivery, women are strongly advised to wear a special postpartum brace or model for those who have undergone abdominal surgery.

This device protects the seam from divergence and creates optimal conditions for tissue fusion, protecting the incision site from muscle tension that can be caused by carrying the baby in your arms, bending over and even breastfeeding. By reducing the mobility of intergrowing tissues, the product contributes to the formation of a neat scar.

The bandage helps to avoid stretch marks (stretch marks on the skin), provides the necessary compression for the muscles that have stretched during pregnancy, and helps to return the abdomen to a flatter shape. Wearing this product plays a significant role in order to reduce the uterus and prevent back pain.

After corporal intervention, the bandage minimizes the risk of:

The optimal models for recovery after cesarean section are a universal brace and a rigid belt. Models in the form of panties or skirts should have a high waist, there should be a rigid insert on the belly, and the fabric of the product should completely cover the seam.

The use of a smaller product, excessive pulling of the torso, redness and swelling of the skin due to a violation of blood supply are not allowed.

When using a bandage, it is necessary to ensure that the fabric of the product does not injure the seam and, if necessary, apply elastic bandages or pads. It should be put on in the morning while lying down and removed only for sleep, water and air hygiene procedures, which takes approximately 20 minutes every 4 hours.

If there are no complications, you can put on a bandage or supporting tissue one day after the operation. It is recommended to wear the product from 3 to 6 months after the operation..

Contraindications to wearing the device are inflammatory complications in the seam area (discharge, redness, soreness, suppuration, fistulas), skin rashes under the bandage area, swelling and severe abdominal pain.

Bath procedures and personal hygiene.

One week after the operation (after removing the threads) and until the suture heals, it is recommended to take a daily non-hot shower.

Do not rub the wound area with a washcloth and apply mechanical pressure when drying: the place of the scar is washed with water with mild baby soap or means for intimate hygiene, and the moisture is removed by blotting movements of a disposable or clean towel, the seam is treated with an aseptic (for example, Chlorhexidine with protection of the near-seam area with "green paint").

Bath, steam bath, sauna, pool and swimming in open water until the end of the recovery period (about 2 months) is prohibited.

It is necessary to monitor the cleanliness of the external genitals and hands. Ideally, if a woman has the opportunity to wash herself after each visit to the bathroom, but washing her hands with soap after using the toilet, walking and communicating with animals is mandatory.

Air baths.

The suture after a cesarean section heals faster under the influence of direct ultraviolet radiation sun rays and fresh air.
Sometimes ultraviolet irradiation of the suture is practiced in hospitals until the mother is discharged and continues on an outpatient basis in physiotherapy rooms. When taking an air bath at home, you should avoid physical stress during the session.

Home activities that accelerate suture dissolution

It is possible to start taking steps to prevent suture coarsening 1-2 months after the operation in the absence of complications.

Methods:

• a solution of vitamin E (alphatocopherol acetate), applied to the scar itself;
• gel and ointments Kontraktubex, Derimatiks and their analogs are recommended by manufacturers for use immediately after removing the stitches, however, their effect on the health of the child during breastfeeding has not been clarified. To some extent, petroleum jelly and moisturizers contribute to scar reduction.

Physiotherapy

After the operation, it is shown lying on the stomach and breathing exercises belly. 2 months after the cesarean section (when the suture softens and the ligature dissolves), you can contact a physical therapy specialist to draw up an individual set of exercises that are designed to speed up the healing of the incision site and strengthen the abdominal muscles.

As a rule, these are exercises with a hoop, a Kegel complex, lightweight exercises for drawing in the abdomen and body turns, lifting and rotating arms and legs. Exercise therapy is designed to accelerate the scarring of the uterine and other internal sutures, therefore, it should not be neglected, but when pain or complications appear, the start of classes is postponed.

How much heal when the stitches are removed: a description by month

The course and duration of healing of sutures after a cesarean section depend on the type of incision used during the operation.

Monthly description of external sutures with normal healing:

Time period	Peculiarities
First 2 weeks	The suture is not yet closed, pain and itching are present
1-2 months	The seam turns into a scar and does not bother, but redness is observed
3 months	The scar brightens, softens, the width of the horizontal scar is reduced, and the color becomes lighter
1-1.5 years	The scar is finally formed, its lightest color and soft state is established. Sealing and wrinkling stops. If you wish, you can start cosmetic procedures to reduce the scar

When should you do an ultrasound of the suture?

Ultrasound examination of postoperative sutures can be planned or prescribed based on the patient's complaints.

Features of the recovery period

The recovery period after a cesarean section is the healing time of the external suture, which is about 2 weeks (one of which is in the hospital stay).

Pain syndrome and itching

Severe pain occurs in the first week after a cesarean section. Normally, painful sensations of varying degrees persist up to 2 months after the operation, itching - up to 3-4 months. Some disturbing painful phenomena can be observed in the first 12 months, especially with changes in atmospheric pressure and changes in weather.

Inpatient pain management methods include intravenous or intramuscular injection non-narcotic analgesic drugs, taking into account the regimen breastfeeding, applying cold to the uterus and breastfeeding for the fastest contraction of the uterus, then warming up.

At the outpatient stage, the doctor informs the doctor about safe pain relief drugs upon discharge; you can also contact the supervising gynecologist or pediatrician. Moderate physical activity also helps relieve pain.

The suture after a cesarean section can be itchy. This phenomenon indicates the ongoing regeneration and does not require intervention. Itching sensations can be relieved with gentle stroking movements, but not rubbing.

If there is a burning sensation, pain is accompanied by reddening of the scar, swelling and fever, or deep pulling pains in the lower abdomen are observed, which are sometimes accompanied by vaginal discharge, then it is imperative to seek medical advice.

Serous discharge.

Serous outflow is a discharge of transparent lymph and ichor, which should end within 1-2 weeks after suturing. If they continue, intensify, and also if blood appears in the discharge, a doctor's consultation is necessary.

In the normal course of the recovery period, the following should not be noted:

• severe bleeding from the outer seam and vagina;
• opaque discharge with a smell;
• redness and swelling of the seam;
• increased body temperature.

Early complications

Early complications are considered to be various adverse effects of the operation that occur during the hospital stay. If one of the following phenomena occurs, you should immediately contact the medical staff of the hospital.

Bleeding

The cause of external (from the incision area) and internal postoperative bleeding, provided that medical manipulations are carried out properly, may be disturbances in the work of the patient's blood coagulation mechanisms, as well as concomitant diseases, such as diabetes or obesity.

Bleeding from the outer seam can occur due to:

• excessive muscle tension;
• stretching of the skin on the abdomen;
• inaccurate medical manipulations when processing and changing the dressing;
• improper connection of blood vessels during surgery.

Uterine bleeding (lochia) with an admixture of mucus is natural within 2 months after the operation, but their abundance should decrease within a week, and the color normally ceases to be bright red. The discharge should not be transparent, watery with an unpleasant odor, purulent, black discharge with an unpleasant odor also causes concern.

With profuse or recurrent bleeding from the incision area or from the vagina, the woman is extended the recovery period in the hospital, the suture is checked and treated, intravenous infusions and iron and vitamin preparations and metroplasty can be prescribed.

Hematoma

Hematoma - hemorrhage from insufficiently strengthened blood vessels under the skin during the operation. Early or inaccurate removal of stitches can be other causes of hematomas.

The contributing factors are diseases:

• kidney;
• of cardio-vascular system;
• blood (eg, anemia);
• phlebeurysm.

Internal hemorrhage is characterized by a feeling of heaviness in the perineal region. Depending on the location and extent of the hematoma, the doctor decides on conservative or surgical removal of the complication.

Suppuration

Inflammation and suppuration of the seam occurs when a bacterial infection develops on dissected tissues when especially viable strains of the pathogen enter the wound or when the patient's immune system is dysfunctional.

The abscess of the wound begins with redness, pain in the seam area, accompanied by an increase in body temperature, chills, loss of strength and the discharge of a cloudy sticky exudate with an unpleasant odor from the wound.

Treatment includes a course of antibiotics and antiseptic treatment of the scar(Vishnevsky ointment, Levomekol, Syntomycin emulsion and others), with a serious complication - drainage. To prevent suppuration from the second day after surgery, it is necessary to get up (gradually, without jerking) and observe the prescribed antiseptic treatments.

Seam divergence

The suture after a caesarean section can diverge due to several reasons. The opening of the edges of the wound occurs due to excessive physical activity of a woman in the first days after childbirth, active sports and weight lifting in the future, as well as due to an infectious process in wound tissues.

Sometimes the discrepancy is caused by overly tight or coarse laundry. Discrepancy of the wound is sometimes observed after removal of stitches and often in women whose child weighs more than 4 kg.

Late complications

Late complications of suture healing are phenomena that occur after discharge from the hospital, usually within 12 months after surgery.

Seromas

Seroma is a vesicular cavity at the suture filled with lymph. Seromas appear in the first weeks after the intervention due to the filling of the dead-end parts of the lymphatic vessels squeezed as a result of the operation and are not a pathological phenomenon. But to differentiate seroma from fistula, medical advice is needed.

Ligature fistula

A ligature fistula is a breakthrough of the site of suppuration of the suture material, when a bacterial infection develops on the surgical sutures (ligature). Fistulas can also appear as a result of allergic rejection of the ligature.

First, any area on the seam becomes hot, reddens, thickens and swells, pain appears, then in one or several places the seam is opened and pus flows out, the overall temperature rises.

The breakthrough site is a through passage through which air can circulate with noise (hence the name of the complication). Self-opening of the seam allows some of the rejected material and purulent contents to come out, however, it indicates a dangerous inflammatory process that requires immediate medical attention.

The initial stage of inflammation is treated conservatively - by aseptic treatment or drainage and with antibiotics. But sometimes the infected ligature must be removed surgically, while the wound is cleared of exudate, a new suture is applied using other materials, and a course of antibiotics is prescribed.

The decision on the scale of the operation and the need for excision of the fistula is made by the doctor. External treatment of the wound with aseptic means at home is insufficient.

If the fistula closes on its own after the separation of the infected material, the inflammatory process continues and relapses may occur, the intoxication of the body continues, which is dangerous with the risk of inflammation of the peritoneum and internal organs and other consequences.

Keloid suture

After corporal cesarean section, keloid (colloidal) coarsening of the surgical sutures is observed as a result of hereditary predisposition most often and represents the growth of dense connective tissue containing collagen. Scars protrude above the surface of the skin, change color, and can cause pain and discomfort.

Hypertrophic scars do not extend beyond the suture and are usually painless; keloid scars grow more extensively. Tissue changes can occur a month after surgery and persist for many years, although stabilization usually occurs within 24 months after the onset of changes.

Such a scar usually does not cause much concern, except for aesthetic, however, if the lump becomes uneven, bumps or discharge appear, you should definitely see a doctor. The specialist will send to ultrasonography and will help to exclude inflammation, ligature fistula and malignant degeneration of tissues in the area of ​​the scar.

Hernia

A hernia occurs after excision of the abdominal tendons during corporal laparotomy as a result of overexertion during heavy lifting, frequent constipation or slow digestion and can be diagnosed many years after surgery. Small hernias require the use of a bandage, large ones require surgical reduction.

The seam has split after a cesarean section: symptoms and actions

The most obvious symptoms are the dehiscence of the external (skin) suture, which are observed more often in the first month after surgery. More dangerous is the inconsistency of the suture on the uterus, the duration of scarring of which lasts for 2 years.

Signs of divergence of the uterine suture:

• pulling pain in the lower abdomen;
• elevated temperature body;
• bleeding from the vagina, especially renewed or intensified a week after the operation.

The only correct decision in this case should be an immediate visit to a doctor.

Symptoms of the divergence of the outer seam:

The suture should be treated with Chlorhexidine, a sterile bandage should be applied, rest should be ensured, and a doctor should be called. If the suture does not diverge much, then re-suturing is usually not required and treatment is limited to local tightening. If suppuration occurs, drainage will be required.

How to get rid of a scar: effective methods

The need to resort to scar correction arises both if a woman wishes to improve the cosmetic appearance of a skin scar, and for medical reasons if a uterine scar is suspected of inconsistency (a “niche” in the uterine suture area).

Metroplastics: efficiency

Metroplasty after a cesarean section is a repeated suture on the uterus in case of previous scar failure. The operation is performed in an open way (laparotomy) or through laparoscopic holes.

The need for metroplasty usually arises after:

• emergency caesarean section;
• inflammatory complications in the area of ​​the uterine suture;
• surgical termination of pregnancy up to 2 years after the previous intervention;
• early pregnancy after the section.

In case of insufficient effectiveness of home methods of dealing with a rough external scar, discussed in the paragraph "Home care", you can refer to plastic surgery and massage. The methods are applicable for fully formed scars (approximately 12 months after surgery).

Grinding: efficiency

In cosmetology, several methods have been developed for resurfacing skin sutures:

Massage: effectiveness

The effectiveness of massage is lower compared to grinding, but it allows you to succeed on small seams or moderately soften rough defects. The massage is carried out after complete healing with pressing movements several times a day for 5 minutes.

The surface of the seam and the skin of the fingers are pre-cleaned, to enhance the effect, moisturizing creams or special means that contribute to the softening of keratin. In parallel, massage will help break down excess fat, strengthen the abdominal muscles and tighten the skin.

Other techniques

To less efficient conservative methods include cryotherapy (exposure to liquid nitrogen), hormonal external therapy, ultrasound resurfacing.

Plastic surgery

Surgical excision is performed on non-extensive scars in order to remove excess connective tissue.

Tattoo

After the suture has healed completely, you can seek the services of a professional tattoo artist. Sometimes successful color and graphic solutions with the inclusion of a seam in the composition can completely mask the scar.

In addition, keloid scars are treated with silicone and zinc dressings, compression devices, injections of corticosteroids, 5-fluorouracil, interferon, and electrophoresis. Irradiation of scars, which was practiced some time ago, is no longer carried out due to the risk of malignant neoplasms.
When to plan a pregnancy after a cesarean section?

After the operation, it is highly recommended to refrain from conceiving the next child for at least 2 years, so that the uterus has time to form a full-fledged scar, the tissues around the seam acquire sufficient thickness and the bearing of a new fetus proceeded without complications.

The optimal period for the next pregnancy is 3-10 years after the cesarean section. Provided that a horizontal sparing incision and a synthetic (or semi-synthetic) ligature at the suture were used in the previous operation, the pregnancy following a caesarean section can be safely resolved in a natural way.

Article formatting: Vladimir the Great

Useful video about caesarean section

Pros and cons of KS:

Currently, the development of medicine has stepped forward, so now the patient has the right to choose the suture thread himself and even the suture technique. If the patient complains of pain in the suture area, this does not mean that the surgeon did something wrong during the operation. However, it is very common to see a lump under the suture after surgery. In this case, be sure to contact surgical clinic or see a doctor.

In most cases, this is due to a complication after surgery, which is called "Seroma". It is a mass in the cavity that is filled with lymph. In general, the seroma usually disappears on its own and does not pose a great danger to the patient. Its formation is associated with the intersection of the lymphatic vessels. And as you know, they, in turn, are much smaller than blood vessels and therefore are not visible to the eye. It is not possible to coagulate or bandage them. The flowing lymph accumulates, thus creating a cavity.

The only serious complication of seroma is its suppuration. To avoid this, it is necessary to treat the area with an antiseptic. postoperative wound... In this case, an antiseptic will be best used in water, not alcohol. It is also necessary to close the scar with a gauze moistened with a solution of Dimexide.

A more serious complication in the event that a seal has formed under the suture after surgery is a fistula. V medical practice fistula occurs as a result of suppuration of scars after surgery. The immediate cause of this kind of complication was implantation contamination, pathogenic contamination of the suture material. In this case, a visible consolidation of the granuloma forms in the fistula area.

The formation of a fistula is very easy to recognize on your own, since the symptoms are quite pronounced: seals or mushroom granulations appear around the contaminated area of ​​the wound; inflammation of the postoperative scar; discharge of pus from the wound; redness in the seam area; the occurrence of sensations of pain, swelling; temperature rise (possibly up to 39 degrees).

Of course, after the operation, seals and formations in the seam area should not be. If suddenly this happens, it is imperative to see the surgeon who operated on you directly, if this is not possible, then to the surgeon at the place of residence. If no measures are taken, such suppuration will lead to the development of an abscess.

What are the reasons for the lumps or lumps on the suture after surgery?

After surgery, patients often complain about the condition of the suture. Complications arise for various reasons. A lump on the suture after surgery is the most common of these. It is not always hazardous to health, and special treatment usually not required. In order to identify the cause of the appearance of the seal, you must consult a doctor. Self-medication leads to the development of complications and the emergence of the need for repeated surgical intervention.

A dangerous symptom is the appearance of a lump on the seam, accompanied by the release of pus. This is a common occurrence, it can be noticed when you independently examine the area in which the intervention was carried out. Problems can arise for various reasons, including: improper suture, the addition of a bacterial infection, the rejection of threads by the human body, the use of low-quality materials. It should be remembered the importance of proper treatment of the area of ​​operation, and if bumps, pain or suppuration occur, an urgent need to consult a doctor.

Types of postoperative complications

Ligature fistula

A lump on the suture after a cesarean can represent a ligature fistula. This is the most common complication. abdominal operations... At the end of the surgical intervention, the incision is sutured with special threads - ligatures. They are absorbable and regular. The healing time of the suture depends on the quality of the material. With proper use of quality material, the risk of complications is minimized. If a thread with an expired shelf life was used, or pathogenic microorganisms got into the incision, then an inflammatory process develops, as a result of which a fistula forms after a few weeks.

It is not difficult to detect this complication. It is a non-healing dense wound, from which purulent contents are constantly secreted. The wound may be overgrown with a crust, but after a while it reopens, and the discharge appears again. The formation of a fistula is accompanied by an increase in temperature, general weakness, and headaches. If a bump and suppuration appear, you should consult a doctor.

Only he will be able to detect and remove the infected thread. If this procedure is not carried out, the seal will constantly grow. Means for external use in this case are ineffective. After removing the ligature, you will need to take some care of the suture, the surgeon will tell you about the rules. If the inflammatory process is present for a long time and is accompanied by the appearance of several fistulas, it is necessary to remove the scar tissue with re-suturing.

Spontaneous seroma

Seroma is an equally frequent complication that occurs after surgery. Unlike a fistula, it can disappear spontaneously. Specific treatment usually not required.

Seroma is a liquid-filled bump. It appears in places where lymphatic vessels lie, which cannot be restored after dissection. At the intersection of the vessels, a cavity is formed, which is filled with lymph.

Seroma, which has no signs of suppuration, is not dangerous to health and does not require treatment. If it is found, you need to visit a surgeon who will make an accurate diagnosis and exclude the presence of an infection.

Keloid scar

A keloid scar is an equally common complication of abdominal operations. It is not difficult to recognize it. The seam coarsens and hardens, its surface becomes bumpy. Pain, redness and suppuration are absent. A keloid scar is not hazardous to health, it is only a cosmetic defect that can be eliminated if desired. The reasons for its appearance are considered to be the structural features of the skin.

How to get rid of a lump on a seam?

There are several ways to eliminate such a defect, it all depends on its type. Laser resurfacing is used to get rid of keloid scars. Several treatments make the scar less visible. Hormone therapy is based on the use of external and general action... Creams help soften the scar tissue, they make the seam lighter. Surgical treatment consists of removing the scar followed by a new suture. This method does not guarantee that the keloid scar will not reappear after the operation.

In order to avoid the appearance of seals at the incision site and some other complications, it is necessary to properly care for the suture in the postoperative period. If a lump or suppuration appears, an urgent need to consult a doctor.

Preventing any complication is easier than curing. The wound healing process takes about a month. During the period of stay in the hospital, all the necessary measures will be carried out by medical workers. After discharge, the patient must learn how to perform all procedures on his own. This is not as difficult as it might seem at first glance.

The first thing to remember is to avoid infection. Timely dressing and proper skin treatment will speed up the healing process. If the lump does appear, you should not try to get rid of it yourself. Seromas usually resolve spontaneously. Keloid scars are not easy to get rid of.

Antiseptic solutions should be used to disinfect the skin in the area of ​​the incision. When using soap, allergic reactions can occur, which makes the healing process longer. Some patients try to get rid of the lump with compresses and lotions. It is strictly forbidden to wet the seam, as high humidity prevents it from healing. Such procedures can irritate the skin and lead to wound infection.

A shower in the first weeks after the operation should take a person no more than 10 minutes. The water should not be too hot or too cold, temperature drops slow down the process of skin regeneration. It is recommended to take a bath no earlier than a month after the operation.

A numb lump near the suture after surgery, what is it?

Numbness near the postoperative scar is, rather the norm than something out of the ordinary. 2 times they sewed me up and both times there were such numbness. Apparently, there the nerves are cut and therefore even tactile sensitivity disappears. Recovers from a couple of months to several years.

This is a normal phenomenon. Numbness can persist for more than one month. During surgery, the skin, subcutaneous fatty tissue, then muscles, and so on are cut in layers. All these tissues have nerve endings, there is innervation everywhere. Accordingly, during tissue dissection, nerve endings and connections, cut too. Hence the loss of sensitivity. After a cesarean section, numbness in the suture area persisted for about a year. Then, gradually, the sensitivity returned.

It will take - a month or two, depending on what kind of operation, a month has passed after the removal of the appendix. He was a bit lopsided, if you look closely and the seal was near the seam, the surgeon friend said that the nonsense would pass.

Consolidation at the suture after surgery

Good day, Natalia!

Removal of the uterus, complete or partial, is performed in gynecology quite often, by various methods, sometimes sparing, removal of the uterus is possible with the fallopian tubes and ovaries or without ovaries and tubes. In the event that the uterus and ovaries are removed, then the woman begins menopause, in which case it is necessary replacement therapy, hormonal in nature.

So, with the complete removal of the uterus, a sufficiently large scar remains, during the first month, compaction in the suture area and discharge of a transparent pinkish character is allowed. You should not abuse baths and saunas, you cannot steam the seam, because it will get wet and will flow, which will noticeably slow down the healing process.

The lump should not be painful, while the discharge should not have bad smell, in no case should not resemble pus or liquid of brown, yellow or other nature.

In addition, you should not lift heavy things, since lifting weights more than 5 kg can lead to the formation of a hernia, which will have to be removed surgically.

The seam must be treated at least 2-3 times a day, it is imperative to let the skin "breathe", since oxygen dries out the skin. Ointments can be applied to the seam: "Lvomekol", "Synthomycin ointment" "Contractubex", they will significantly speed up the healing process. You can process the seam with hydrogen peroxide, brilliant green, furacilin, chlorhexidine, potassium permanganate solution.

Subsequently, you can take baths with a decoction of chamomile, calendula, potassium permanganate and a weak solution of baking soda.

Before going outside, it is worth putting a bandage on the seam, giving up linen and clothes that rub or press on the seam or the area around the seam.

In the event that any kind of problem arises, then you should contact the gynecology and do an ultrasound of the suture.

There is a seal on the scar: what to do?

After the operation, doctors put stitches so that the wound heals quickly and correctly. Usually this process proceeds normally, but sometimes the wound can fester for a long time, or after it heals, various formations are found in the seam area. In any case, don't panic. If you feel a seal on a scar, this does not mean that you have something irreversible. It can be a trivial knot from a seam. But first things first…

How does a postoperative wound heal?

Modern medicine has made great strides forward and now the patient has the opportunity to choose not only the doctor who will perform the operation on him, but also what material and technique will be used for suturing. After all, the latter is an important part of the surgical intervention. If some kind of violation occurs during this period, subsequently this leads to many problems. Including the formation of suppuration and seals on the scar or under the scar (as if in the depths of the skin).

However, not always such "bumps", which are felt by many surgical patients, speak of a medical error or a pathological process.

How does it heal postoperative suture? This takes place in several stages:

1. Blood clots form at the edges of the wound, which "seal" the blood vessels to protect the body from blood loss. Then a large number of leukocytes arrive there, the purpose of which is to prevent the harmful effects of dangerous microorganisms. If the leukocytes do not cope with their task, severe suppuration begins, which requires the use of antibiotics.
2. Healing begins with the fact that the wound cavity is filled with special connective cells that gradually form a scar. This process takes from two months to a year.
3. When the scar is already formed, part of the blood vessels and cells in it atrophies, the scar becomes less noticeable.

At what stage of the process does a seal appear on a scar after surgery? This is usually the first or second stage. This can be both a signal that you need to urgently see a doctor, or not mean anything serious.

Our video. Treatment of facial scars

Aids

Often, especially if the wound was large, after the operation, doctors prescribe additional drugs, which should speed up its healing. And also to stimulate the resorption of the scar and various seals in him.

Silicone ointments or plasters are now very popular. Numerous user reviews about the condition of seals from scars before and after their application indicate that this is one of the most effective preventive and remedies... The only thing to keep in mind is that these remedies only help if you apply them on time. The sooner the better.

When the scar is a year old or older, ointments, creams, or home remedies won't help. Therefore, if suddenly your doctor forgot to prescribe a scar resorption aid for you, ask him to do it. Treatment started on time is a guarantee of the absence of problems in the future.

Homemade Super Recipe! Memo for you

Causes of seals on scars

So, here's what it might mean if you probed the scar and found a seal under the scar:

• This is a knot from the thread that was used to sew the wound. In this case, you should not experience any pain. Over time, all threads and knots dissolve by themselves.
• Over a caesarean section scar, induration is often the result of inner seam... The wound is sutured in several layers, and therefore, on the surface of the scar, women often grope for various dense balls, which after a certain time completely disappear. If nothing hurts, there is no point in worrying. The complete healing process can take more than a year.
• Compaction after a scar can also be pathological if it is a complication after surgery. In some cases, patients have seroma. It is formed due to the intersection of the lymphatic vessels. By themselves, they are very small and cannot be tied or sewn up. Because of this, the lymphatic fluid flows out and accumulates in small cavities, which is felt like a dense ball. This phenomenon does not pose any danger and over time all the balls dissolve. The patient must follow the doctor's instructions and care for the healing wound so that the seromas do not become infected.
• The most dangerous hardening of a scar after appendicitis or any other operation is a fistula. If pathogens get into the scar and it becomes inflamed, dense balls are felt in it, which bring pain when touched. Pus can also ooze from it, but not necessarily, since sometimes it accumulates under the skin and cannot come out. In this case, the temperature rises. If you observe such symptoms, you need to urgently call an ambulance.

If the seal does not hurt and does not cause any discomfort, there is nothing to be afraid of. But if you are still worried, consult a doctor so that he dispels all your doubts.

Exclusive video. Treatment of scars with folk remedies

To remove the seal under the scar, both the use of special absorbable agents, which are prescribed only by a doctor, and simply time can be used. Sometimes you have to wait a certain amount of time. The larger your scar or the harder it heals, the longer you will have to wait.

Sealing under the seam

Sealing under the seam after x

Even in the maternity hospital, they applied Vishnevsky to me after cleaning the seam.

All three times she treated only with household soap.

Hard under the seam in a child

I would go to the surgical reception to show

Lump over and under the seam after cesarean

contact gina

in a month they should look at the ultrasound as the state of the seam

seals under the outer seams

Sealing under the seam at the site of removal of atheroma!

lump over or almost on the seam inside the abdomen under the skin after CS

The meat under the seam hurts after the episio!

I am very sorry for your baby ... I used to often come across your posts in the feed, read, and then suddenly ... I really sympathize with you! You will still be the most wonderful mother of the most adorable baby! Hold on.

maybe I will not be right - my mother advised sea ​​buckthorn oil, I was lying in the room there, smearing it with it, I don’t remember exactly, but it seemed there was a ray from him. and then it also hurt wildly and there was a terrible seam (by the way, it healed like there was nothing).

My condolences.

Lump after caesarean section

It will pass, I also had my abdomen cut 4 times along the same seam.

is there redness? try this hot seal or how is all skin the same?

seam after cop

maybe you will feel this too)

Spike. It is necessary to see a doctor.

Lump or lump under the cesarean suture

I had this after six months, it turned out that the thread that was not sewn did not take root, came to the surgeon, an injection of lidocaine, made a small incision, took out the thread, 4 days of dressings and everything is in order) it was only painful for 1 dressing)

Honey, maybe that's why there was a cycle failure and copious CDs?

Of course run to the doctor tomorrow. Don't panic, the main thing. You go, see, and tell you what to do.

Will the overhang of the skin over the suture go away after cesarean?

Problems with the seam after 5 years.

I had it after 1 ks, only it became sick after 1.5 years, too, with menstruation. the ultrasound was done, the thread did not dissolve, it was removed surgically

Well, no matter how an ultrasound of the suture would not hurt to do it for a long time ... you never know ... a hernia or what is even worse can come out ... watch your health.

I had. Yes such a seal. A week later the blue and yellow bruise bloomed. It turned out to be an internal hemotoma. It won't help you with anything but ointment… it will dissolve itself over time. Not less than a month.

If about an ipiziotomy, then there was a strong seal for the first 1.5 weeks, then less. Now there is almost no. I was told that the seal at the beginning of time is normal.

There are also seals, the doctor says that everything is fine

Again about the COP

I had one bump on the left side, but it resolved itself over time. But I don’t remember that she was particularly sick. I still have an uneven stomach) There is a slight rise on the left side, but this is most likely due to some kind of stitching defect

At least you need to see a gynecologist. I went to a scheduled appointment with a gynecologist 6 weeks after giving birth. He touched the suture, did an ultrasound of the uterus and suture.

I also had seals along the edges of the seam, passed

Girls who passed the COP take a look

About the seam. I believe that if everything is normal on the outside, then everything will heal. When you touch the seals, then in the place of the seals there is no more than, where are there fewer of them? Now I touched my seam, there is nothing under it ... And in the beginning I was afraid to look there, not to touch)))

bloating, the body is slowly returning to normal, this is all normal and with a seam, too, I have done cesarean twice already do not worry, everything is normal in a year

If there are no sharp and severe pains, then everything is fine, and the seals are so sewn up your muscles, it was the same, then everything became equal, now I don't feel anything at all

bump on the seam from the COP

Be sure to take the time and go to the G and the surgeon! I'll tell you about myself ... after my COP in 6 months. a lump also appeared, it did not hurt and did not bother me, I went to the ultrasound, they said a spike like all the rules, 4 years have passed after the COP and this "spike" began to grow ... and began to bother me a little (this lump either turned red or blue a little, especially before and during menstruation) it was the same as in your photos ... in general I was scared ... and ran to 10 doctors to find out ... they attributed to me either a hernia, or threads, or adhesions in general, in surgery, they decided to cut ... it turned out that this was a consequence of the EKS ... and it is called: postoperative endometriosis a scar of the anterior abdominal wall ... certainly nothing fatal, BUT. what kind of muck you can read in the net ... so do not leave this matter for later. PS. I do not want to intimidate you in any way, I just had it like that ...

Mammologist - online consultations

Sealing around the seam

No. Mammologist 03/03/2014

Hello, I had an operation to remove a node in the left breast. Today, 5 days after the operation, the temperature is not normal. The node is benign. I am worried about the seam of the seal and apparently during the operation the vessels burst that near the nipple like a bruise in the form of a titmouse. Please tell me the seal should be so? And isn't the bruise terrible?

Hello, Natalia! In principle, after the operation, there may be a suture seal, a hematoma in this area. Sometimes these changes go away on their own, and sometimes you need a doctor's help. If you are confused by the seam, I strongly recommend that you see the operating surgeon.

The seal described by you with equal success can be a variant of the norm (due to surgery), and a sign of the development of a hematoma, seroma, etc. It can be said for sure only after an ultrasound scan.

REFINING QUESTION 03/26/2014 Danilova, Natalia

Yes, you couples, an ultrasound showed me that the seal near the seam is a seroma. Today it was pumped out. The doctor recommended making a vodka compress for two days as it could get inflamed. He did not appoint any treatment. And in the future to be observed. Maybe I should drink some antibiotics for inflammation. But I'm worried about whether the fluid can accumulate again and what kind of complication can it give? How long does it take to make a control ultrasound? Thanks in advance.

Control ultrasound is performed immediately after the puncture, then the next day, then after 3-5 days. As for the advisability of taking medications, then it is decided strictly individually.

Seals on the eyelids after blepharoplasty - complication or norm?

The recovery period after aesthetic surgery is not always smooth. The process of tissue healing has its own characteristics and its own, individual for each person, speed.

Seals after blepharoplasty appear under surgical sutures or in the immediate vicinity of them, most often when correcting the lower eyelids. Typically, patients describe their problem using the words "lump", "pea", "roll" or "sausage". In fact, these can be very different formations:

• forming scar tissue - the most common option, in many cases it is not considered a problem, there are high chances that over time, the excess volume will dissolve by itself;
• local edema at the suture site - also refers to the expected and harmless consequences of plastic surgery;
• cyst - a consequence of incorrect suturing of the incision;
• bulging of the eyelid in violation of the connection of the cartilage of the ciliary edge of the eyelid with the muscle;
• lumps of fat at the site of lipofilling complementary to blepharoplasty;
• pyogenic granuloma.

Thus, we can talk about both a variant of the norm and a developing complication. In this article we will talk about the reasons for the appearance of each of the above-named seals and what treatment should be.

Violation of scarring processes: the main factors and consequences of their influence

The formation of scars at the site of surgical incisions is a natural and inevitable process, for more details about its course, see the article "Stages of scar formation". The appearance of puffiness in the first week after blepharoplasty and the presence of excess connective tissue within 2-3 months after the operation are inevitable side effects, for which you need to mentally prepare in advance and not panic. At the same time, these processes can have individual characteristics:

• In some patients, already lower on the eyelids, no traces of intervention remain, while in others, even after several months, "bumps" along the seam are well felt under the skin, and sometimes they can be seen with the naked eye.
• The rate of resorption of the seals can be different on the right and left. In addition, the scar itself is often heterogeneous along its length - the end sections of the incisions located in the corners of the eyes retain the volume for the longest time.
• Due to natural edema and active proliferation of connective tissue, scars can look like they are located directly on the outer parts of the eyelids for a long time. This is not a surgeon's mistake, but a feature of tissue healing. As the excess collagen is absorbed, the marks at the incision sites will turn into thin stripes, hide in the natural folds of the skin and no longer remind of themselves.

In most cases, similar scarring appears after an inferior blepharoplasty. Normally, they should dissolve after 12 weeks - in addition to individual characteristics of the organism, the technique of performing incisions and sutures, as well as the total volume of the intervention, is important here. An adverse effect on tissue healing processes is exerted by:

• chemical and thermal burns: exposure to laser radiation, as well as irritating, drying solutions, including those used for the purpose of disinfection, etc. That is why you will have to forget about peeling of the area around the eyes after blepharoplasty for a while;
• suppuration: the presence of an inflammatory process in the wound always leads to an excessive proliferation of connective tissue;
• incorrect alignment of the edges of the incision, strong skin tension and other errors of the surgeon when suturing;
• disruption of the immune system;
• hereditary predisposition to excessive proliferation of connective tissue in response to damage (the formation of hypertrophic scars or keloids).

In addition, excessive physical impact on the injured skin areas can lead to compaction of the seams - in particular, the habit of rubbing the eyes after waking up and active massage of the operated area (many patients "prescribe" it to themselves in the hope of dispelling the swelling). The fact is that the collagen fibers of the young scar are located chaotically and cannot withstand the stretching of the wound edges. To avoid these complications, doctors usually apply special strips over the sutures and strongly recommend not to touch the eyelids with your hands in the first weeks after blepharoplasty: any physical effect promotes blood flow, increases the rate of collagen formation, prevents the resorption of excess connective tissue - as a result, instead of thin "threads »Rough scars may remain on the eyelids.

If large fibrous cords nevertheless began to form at the site of the incisions, you need to contact the specialist who performed the operation, another plastic surgeon or a dermatologist for help:

• Do not self-medicate! The simplest advice, and often the hardest to follow: follow the recommendations of the surgeon who performed the surgery and give the body time. Usually, for the first few weeks, the doctor prescribes healing drugs, then special anti-scar ointments and / or hardware procedures can be added - microcurrent therapy, lymphatic drainage, etc. The process is accompanied by regular examinations, and if something goes wrong, the specialist changes his assignment.
• A few weeks after the operation, the doctor may decide to speed up the process of resorption of connective tissue through injections. hormonal drugs- glucocorticosteroids. In some cases, local application of them can be dispensed with, but only after the incisions are completely healed.
• If the cicatricial bumps remain in sight and continue to remind of themselves 2-3 months after the operation, the tactics of their treatment can be revised again - up to excision. But sometimes you just need to wait: the natural "displacement" of the stitches into the folds of the skin can take quite a long time due to the fact that edema after blepharoplasty sometimes persists for up to 6 months.

Nodules at the site of suture absorption

For fastening the edges of the surgical incision in the eyelid area, as a rule, atraumatic thin threads with a round cross section are used, which are completely biodegradable over the course of a day. This process is impossible without the participation of the immune system of our body, which enhances circulation in the area of ​​detection of a foreign body. The active flow of blood and tissue fluid to the site of the suture imposed causes local edema, which, upon external examination and palpation, can be defined as "bumps", "peas" or "nodules". Normally, as the threads dissolve, all such seals gradually disappear. This process can be disrupted by:

• slowing down of blood circulation in the area of ​​the surgical wound, when due to the general massive edema, the outflow of blood through the venules and veins is difficult, stagnation of tissue fluid is observed;
• disorders in the immune system;
• too superficial arrangement of threads in the skin.

The latter option is the most common. In this case, only individual pieces of threads will dissolve, and their other fragments will be cut to the surface. This situation is not considered a complication, since the "extra" suture material is easily removed, and the injured skin heals quickly and without a trace.

If the problem is swelling, then this is just the case when a good massage will help. Only it must be carried out not at random, but according to the correct technique - so as to stimulate the outflow of lymph and venous blood, normalize the flow of arterial blood rich in oxygen and nutrients, and tone the tissues. The surgeon will tell you what the movements should be. He will also recommend the correct frequency and duration of sessions.

In general, the biodegradation of the threads can be expected up to 2-2.5 months. If during this period the seals caused by them do not disappear, the doctor can make small incisions or punctures in the skin and remove the suture material, or prescribe a course of special absorbable drugs in injections.

Lumps of fat

If blepharoplasty was combined with lipofilling, indurations different sizes may appear due to the uneven distribution of the transplanted fat cells, as well as if the graft was not processed well enough and lumps remained in it. This complication is especially noticeable on the lower eyelids, since the skin is very thin here and any, even a small "nodule" immediately appears on the surface. Over time, the lumps may spontaneously dissolve, but they may remain unchanged. There are several working methods for treating this condition:

• massage, which at an early stage of engraftment allows you to make the seals flatter and even out the skin surface;
• the introduction of fillers based on hyaluronic acid - they are able to smooth the boundaries of the fat lump and temporarily make it less noticeable;
• repeated lipofilling to correct the unsatisfactory result of the first procedure - works in the same way as contour plastic with fillers;
• liposuction of excess, bulging fat cells.

In each case, the most suitable of the options for correcting the arisen defect is determined by the plastic surgeon.

Cyst on the eyelids after blepharoplasty

This seal is usually located in the immediate vicinity of the operating incisions and outwardly looks like a yellowish or whitish ball. By its structure, it is a cavity filled with liquid.

The reason for the development of a cyst is improper treatment of the edges of the wound, when areas of the epithelium are immersed deep into the tissues when sutures are applied. The content accumulates gradually, which leads to a constant increase in the volume of the neoplasm - as a result, it can grow up to about 0.5 cm. The duration of the defect is from 1 to 3 months. During this period, he must be monitored without taking any action. If after 12 weeks the cyst does not resolve on its own, it is surgically removed.

Pyogenic granuloma (botryomycoma)

This vascular neoplasm is benign in nature and develops on the lining of the eyelid in response to tissue damage. To start the process of abnormal proliferation of blood vessels, sometimes minor microtrauma is enough, not to mention full-fledged incisions, carried out during blepharoplasty.

Pyogenic granuloma has the appearance of a round or lobular formation of a dark red or burgundy color up to 2 cm in size. Growing up to a large volume, it can lift the skin of the eyelid, palpable when pressed. The term for the appearance of botryomycoma varies widely: in some cases, the neoplasm appears already a few days after the operation and rapidly increases in size, in others, its growth can begin only after 2-3 months.

• If there is a dark red seal on the mucous membrane of the operated eyelids, there is no need to massage it, rub it with ointments and irritate it in any other way. All efforts aimed at resorption of the "pea" can give exactly the opposite result: the neoplasm can begin to bleed, accelerate its growth.
• It is not difficult to remove such a granuloma. After confirming the diagnosis, it is surgically excised or vaporized with a laser. Moreover, there is no particular urgency in this procedure, so the surgeon will appoint the time of its carrying out taking into account the state of the operated tissues of the eyelids.

As you can see, there is no single reason for the appearance and universal procedures for removing seals on the eyelids after blepharoplasty. It is important that according to external description, even with a photograph, it is not possible to establish the cause of the development of a "nodule" or "bump". Therefore, in order to accurately determine the nature of the problem and receive personal recommendations for its treatment, it is necessary to consult a doctor in person - preferably with the surgeon who performed the operation.

Why does a seal appear after a hernia operation?

Compaction after a hernia operation does not always indicate some kind of error on the part of the surgeon. Most often this is a consequence of natural scarring of the tissue and seam, after which the skin and other tissues begin to actively regenerate. Plus, when the seam dissolves, the flesh becomes slightly inflamed - this is a normal reaction of the body. This occurs in the percentage of all operated patients, so there is nothing to be afraid of.

Complications

However, it should still be mentioned that complications after the elimination of the hernia can indeed be. They are connected:

• with infectious infection;
• with the rejection of the mesh prosthesis, with the help of which the muscles are tightened and the repeated rupture of tissues is prevented (this can occur due to ignoring the doctor's recommendations);
• with seroma (filling the cavity with lymph).

Regarding the latter (seroma), it is absolutely safe. In the place where there was a hernia earlier, after the operation, an empty cavity remains between the skin and the muscle "canvas", thus tightened by the mesh prosthesis. It fills with fluid - lymph, but disappears by itself within 1-2 weeks. When pressing on it, the patient does not feel any unpleasant sensations, discomfort. Pus does not come out through the seam either, and an unpleasant odor does not come out.

In rare cases, the seroma can be felt within 3-4 weeks, but not more. During this time, the skin regains its original shape and elasticity. The cavity disappears, and a normal fat layer forms between the skin and muscles.

Infectious contamination is also a rare case. It occurs due to a medical error, in which pathogens enter the suture material. Inside it forms like a seroma, but it is filled not with lymph, but with purulent material. All this is accompanied by a sharp increase in body temperature (up to 40 degrees), when pressing around the seam and in the area of ​​compaction, the patient feels a sharp pain. If these symptoms are detected, it is necessary to consult a doctor as soon as possible for a second operation. Re-replacement of the mesh prosthesis may also be required.

With an infectious infection, there is a high risk of the appearance of not only a seal (which over time increases to the size big bump), but also blood poisoning. The main thing is to treat the wound and cavity as soon as possible, to remove pus. This is accompanied by taking antibiotics. wide range actions.

Mesh prosthesis

Despite the fact that mesh prostheses are made from materials that are completely neutral to the human body, rejection can occur.

Most often - due to non-compliance with the surgeon's recommendations, when the patient refuses to get out of bed, or after initial rehabilitation (discharge from the hospital), begins to lift weights and does not limit physical activity... The prosthesis is simply separated from the muscle tissue, and the hernia reappears. All this can also be accompanied by suppuration, the appearance of an elevated temperature.

The same will happen if the postoperative suture is improperly processed and the infection is allowed to get inside. First, the scar begins to actively itch, then a burning sensation appears. After 1-2 days, a seal appears around the seam - these are inflamed tissues. They should not be allowed to die off, as the process of natural decay will begin.

There are other complications after an operation to eliminate a hernia, but they are either extremely rare or purely individual (for example, filling the cavity with fatty tissue) and do not carry a certain danger to the patient's health.

Seals after surgery.

Good day! Two weeks ago I had a lower blepharoplasty operation, under the seams there were seals in full length under the seams. I am very worried about this, it's time to go to work, but the view is terrible. The doctor says that everything is fine, but I see that it is not. What should I do?

Yes, indeed, after performing the lower blepharoplasty, the edges of the skin are usually denser and in order for these internal tissue edema to pass faster, microcurrent lymphatic drainage is performed, which accelerates healing. Obviously, when you need to go to work, you should use decorative makeup or wear smoky glasses.

Plastic surgeon, doctor of medical sciences

Hello. Such a situation may be, this is the process of scarring. After a while, the scars will soften. In this situation, you can use Hydrocortisone ointment, apply to the suture area, perhaps the ointment will slightly remove the puffiness and speed up healing.

Unfortunately, it is impossible to say anything without inspection.

Hello. Excessive scarring may be expressed due to specific features surgical technique or your personal healing habits (which is less likely). Diprospan blockages can reduce the severity of this process, but your doctor should have experience in performing them. If you have the opportunity, you can seek advice from the GrandMed clinic.

Delivery by caesarean section is a surgical procedure in which the baby is removed through an incision in the abdomen. lasts 3 to 6 months. As it heals, a scar forms on the uterus. Problems with a suture after a cesarean section occur quite often. They are provoked by poor-quality care, violation of the principles of the operation, infection, etc.

Important! If a seal has formed over the seam after cesarean, you need to immediately consult a doctor to identify the sources of the pathological process.

Reasons for compaction of the suture after cesarean section

Surgical manipulations involve stitching the soft tissues of the abdominal cavity using medical instruments. The choice of material is carried out on an individual basis, depending on the type of operation.

After surgery, the seam is gradually covered connective tissue leading to the formation of a scar. Under the influence of certain factors, the scar is not formed correctly. This manifests itself in reddening of the skin and the appearance of induration. TO possible reasons such a phenomenon includes:

• appearance;
• tissue infection;
• the formation of a purulent process;
• the body's autoimmune response.

Most often, after a cesarean section, the suture is hard due to infection in an open wound. Poor hygiene during the recovery period or neglect of the gynecologist's recommendations can provoke a problem. The first time after childbirth, an appointment may be required. If the seam is hard and hurts, required urgently visit a specialist... This situation requires timely treatment.

Types of caesarean section sutures

Complications after surgical procedure can touch any kind of seam. In medicine, they are divided into: internal, horizontal and vertical seams. In the first case, we are talking about those that are superimposed directly on the area of ​​the uterus. There are different ways of applying medical threads.

The doctor focuses on the need to prevent bleeding and ensure the woman's ability to carry in the future. When carrying out a laparotomy, it is customary to make a transverse suture. When carrying out a corporal operation, the longitudinal internal one is most relevant. The uterus is sutured with synthetic strong threads, which eventually dissolve on their own. After that, stitches are made on the abdominal wall.

Vertical
Transverse

The vertical suture starts from the pubic area and ends at the navel. It is applied when there is a high risk of hypoxia in a child and profuse blood loss in a woman. Such a seam is considered a significant visual defect. He tends to hardening in the future.

Most often, they tend to remove it by the method of laser exposure or make it. The horizontal suture is in the crease above the pubic region. Its physiological location makes it as invisible as possible. This method of tissue joining is preferred when the operation takes place without complications.

Why did a bump appear over the seam

The hardness of the skin at the site of the incision during the recovery stage is considered absolutely normal. If there is no pain signal and purulent masses, there is no need to worry. Softening of soft tissues begins only one and a half years after surgical procedures. A lump on the seam indicates the development of a pathological process. In this case, you cannot do without visiting the gynecologist's office.

Do you have a vertical or transverse seam?

VerticalTransverse

A lump of any size can precede the formation. Ideally, later certain period time after the operation, the stitches imposed on the uterus should dissolve on their own.

If this happens for some reason, the inflammatory process begins. Purulent masses accumulate under the skin. After a while, a purulent head forms on the lump, through which dead leukocytes come out.

At ligature fistula at the site of scar formation, a throbbing pain appears, the skin begins to redden. Bursting sensations may be present. It is extremely important to see a doctor on time and start therapy.

Sometimes seals after a cesarean section provoke violations of regenerative processes. In medicine, a scar caused by such a cause is called keloid. It does not pose a threat to the patient, but it is distinguished by its aesthetic unattractiveness, which causes psychological discomfort. It is recommended to remove such a scar with a laser.

Another common complication of surgical procedures is seroma. It differs from a fistula in that it can disappear on its own.

Seroma- This is a pathological seal in the suture zone, inside of which there is a liquid content. It forms at the intersection of the lymph nodes. Sewing soft tissue in this area after dissection is almost impossible. In this place, a cavity is formed in which lymph accumulates. After detecting a seroma you should visit a doctor to determine the cause of the pathology.

One of the early complications is considered. This usually occurs 7-10 days after surgery. The reasons for the divergence of the seam include the lifting of heavy objects weighing more than 4 kg and the transfer of infectious diseases. This condition is very dangerous for a woman's health. It is important to consult a surgeon and / or gynecologist on time in order to prevent complications.

Obvious symptoms

After a cesarean section, the suture hurts anyway. So pain syndrome is considered a subjective sign of a pathological process. To eliminate pain, analgesic drugs are prescribed. They are taken immediately after the operation. The duration of pain in the seam area depends on its type. The transverse suture requires complete healing no more than 6 weeks... The longitudinal suture ceases to bother about 60 days after delivery. Other symptoms of pathologies include:

• itchy sensations;
• purulent discharge;
• hardening of the seam;
• low-grade or high body temperature;
• deterioration of health;
• bleeding of the seam.

The internal suture after a cesarean section tends to dehiscence. In this case, the woman has bloody discharge. Since the first time after delivery, it will be difficult to understand the nature of the origin of the discharge. Their number will increase significantly. Foul odor and blood clots may be present.

Excess body temperature- the main sign of inflammation in the body. The phenomenon is observed due to the fact that the immune system trying to resist a viral or infectious disease... Subfebrile or elevated temperature is accompanied by a decrease in performance and chills.

Many women in labor are worried about itching sensations in the suture area. In fact, they are completely safe, indicate that the wound is tightened with connective tissue, that is, heals. With severe itching Absolutely forbidden comb the seam. If there is a burning sensation, then you need to see a doctor.

When to be wary

You have already consulted a doctor

YesNot

The development of complications is not immediately apparent. At the very beginning, the clinical picture is blurred. By itself, a hard suture after a cesarean section is not dangerous.

It is necessary to pay attention to the accompanying signs of deviations. Normally, the scar does not rise too much above the skin surface. Near shouldn't be swelling and redness.

An accumulation of pus, open wounds, an unpleasant odor, and throbbing pain indicate the development of inflammation. Should inspect the seam regularly and listen to your feelings.

But the most reliable diagnostic method is timely visits to the gynecologist. The doctor will be able to detect the problem by visual examination. Particular care should be taken one week after surgery. During this period, it is very easy to get infected.

What to do in case of complications, the doctor decides. An ultrasound scan is done beforehand to exclude the likelihood of scar tissue divergence. Tests are also taken to detect the presence of inflammation in the body. After collecting the data, a treatment method is selected. Consolidation of the suture after cesarean disappears approximately 10-12 months after the operation. Otherwise, it is removed in a cosmetology clinic.

Treatment

The method of therapy for compaction at the seam after a cesarean section is selected taking into account the cause of the pathology. For the healing of purulent formations, treatment involves the use of antimicrobial agents. The seam area is regularly treated with antiseptic solutions. Antibiotics are administered orally or by intramuscular injection.

According to statistics, scar dehiscence is possible in 4-10% of cases... This is due to the anatomical features of the structure of the muscles of the abdominal wall in women. If the seams diverge, a second operation is required. A ruptured uterus is extremely dangerous for a woman's life, so there is no need to delay treatment.

Fistula is treated with surgery. The main cause of the pathology is a medical thread stuck in the soft tissues, from which suppuration began. It can only be removed surgically. The surgeon opens the wound, removes the foreign element and gets rid of the purulent masses. After the operation, the woman is shown anti-inflammatory therapy.

The lump over the seam, which is not accompanied by an inflammatory process, may disappear on its own over time. But in any case it is necessary to show it to the doctor. The need for treatment of a keloid scar is determined by the woman herself. This pathology brings only aesthetic discomfort. A scar after a cesarean section is removed by surgical excision or more conservative methods:

• chemical peeling;
• ultrasound treatment;
• laser removal;
• hormone-based ointments;
• exposure to liquid nitrogen.

The most effective method for removing a postpartum scar is a laser procedure. It is distinguished by the absence of painful sensations and a high degree of effectiveness. After 2-3 procedures, not a trace will remain of the scar. The disadvantages of this method include high cost. In most cases, such an operation is performed in private clinics.

Topical products are hormone-based. Their use helps to make the scar less visible. The disadvantages of the method include the cumulative effect. To see improvement, you need to use the cream for a long time.

The surgical method of treatment has many opponents. During the operation, the scar tissue is completely excised. Then the scar is reapplied. There is no guarantee that the situation will not repeat itself.

Preventive measures

From quality preventive measures the degree of risk of developing undesirable consequences after surgery depends. First prophylactic aid is provided to a woman in labor immediately after surgical procedures. Factors that can provoke infection into the uterus are eliminated. The stomach after a cesarean section is periodically smeared with brilliant green.

The stitches are removed after about 7-8 days. At this stage, the likelihood of complications is highest. After the end of the period of stay in the hospital, home care begins, which includes the following nuances:

1. It is strictly forbidden to lift weights and play sports.
2. If there is a discharge from the rumen, it is necessary to carry out regular treatment with an antiseptic solution. The attending physician will tell you how to carry out the procedure correctly.
3. At first, it is recommended to wear it, which allows you to support the muscles of the peritoneum.
4. One month after cesarean suture solid. This is considered normal, but at this stage, you can take measures to soften it and fast healing... For this purpose, special regenerating ointments and creams are used. It is often recommended to use Contractubex ointment.
5. Sexual intercourse at the stage of recovery is strictly prohibited.
6. It is recommended to pay attention to nutrition during the recovery period. The presence of vitamin E in the diet helps to speed up the regenerative processes.

The complication can go away on its own, but this does not mean that the problem should be ignored. Regular visits to the doctor will help to identify visible signs of abnormalities in time.

Opinion of doctors

A seal over the suture after a cesarean section most often appears as a result of infection. The uterus in the recovery stage is extremely vulnerable to pathogenic microorganisms. Lack of hygiene and refusal medical supplies leads to wound suppuration. This is dangerous not only for health, but also for a woman's life. If you do not consult a doctor on time, the following complications may follow:

• internal bleeding;
• rupture of the uterus;
• sepsis;
• fatal outcome.

With acute inflammatory processes associated with the appearance of pus, the help of a surgeon is needed. Only a doctor will be able to exclude further complications by choosing the appropriate method of treatment. If nodules occur in the suture area after a cesarean section, you should immediately consult a doctor, even in the absence of other alarming symptoms. Help in the form of surgery in this situation is invaluable.

After the second and subsequent operations, the woman should again adhere to the recommendations prescribed by the specialist.

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