Episiotomy re-opening 15days post-partem

[Oeisha]

OK, so it was a very neat episiotomy and I've been generally doing OK with it.

Stitches fell out 2 days ago in the area affected. Checked in the bath today as I've been feeling a lot of 'pulling' (which I was told was normal). It looks like the episiotomy has started to come open (surface only, but obviously so) by anout 2cm...

..who should I contact? Is is something my GP can deal with, or will this mean a hospital visit? There is a MWLU 2 mins away from me...but didn't give birth there...gave birth in a hospital 40mins away.

I would start with the GP, insist on a an emergency appointment tomorrow, explaining the situation if necessary in graphic detail to the receptionist.

Thanks bonzo. My GPs surgery owe me BIG TIME after failing to answer the phone for over 45mins 2 evenings ago, the OOH guys ended up taking pitty on me and taking me on as they also couldn't get through on the 3 direct numbers they had. Bad mastitis...
Already on anti-biotics for mastitis so will ring them in the morning.

OMG...phoned GP who told me to phone MWLU (who were responsible for antenatal and post-hospital care), who said I should be seen and to phone hospital as they did procedure, who told me to phone and see GP as discharge has changed...but they thought it was proibably ok...
GPs surgery is insisting I have a phone consultation with a nurse who can then refer me to a GP if she feels I need it...so the TWO midwives I've spoken to don't count...if I don't see a doc today I will be making an appointment with the practice manager about this week...

That sounds very frustrating - at only 15 days post delivery I would really have thought a midwife or obstetric doctor should be checking your wound- after all they see them on a daily basis and will know straight away if there is a problem. Sounds to me like the hospital is passing the buck to your GP so I have some sympathy for them, however then having to wait to speak to a nurse to get an appointment is ridiculous. You will probably end up with an appointment for this evening, and the GP will then have to ring the hospital for advice anyway unless they have prior obstetric experience! The NHS at its best hey! Hope you get sorted out soon

Si, saw dr...nurse asked 2 questions and then booked me in asap.
Dr's taken some swabs and would have put me on antibiotics, but thanks to mastitis I'm already on them. Otherwise it's all looking ok - thank god. Thanks guys!

Hello oeisha how are things now? A similar thing happened to me and it wasn't very nice at all. But I'm expecting no2 now :) congrats on your baba!

Not to be too grim but.... I'd just like to say make sure they put in stitches if required. That's your pelvic floor muscle and if it's not fully intact then it can lead to big problems in supporting your organs and prolapse - i'm under 40 and speaking from sad experience here! Healing nicely is not the same as healing fully closed up!

All seems ok. They swabbed some discharge but I've not heard anything yet. Need to ring Thurs for results.
Doc was very sure everything was looking very good. S fingers crossed all is ok.

I had this - apparently I just didn't 'knit' together as I should have. I did ABs and lots of baths with savlon (I think?) salts.

My gp sent me back to hospital but they didn't restitch - apparently they just don't do this (at least where I live).

It does heal. I promise.

I'm bathing with teatree oil and salts, bathing DD, then topping up with the salts and oi (and leaving DH to do all the screaming post-bath changing!). Seems to be doing the trick nicely...oh and thanks to some rather unwated piles I'm also applying hypercal to them, so I suspect there's a bit of overspill from that too.
I was particularly worried as I've "reacted" to disolvable stitches before...either that or it was just very bad luck...they basically just pulled and pulled and gave me an infection after 2 days...but this hasn't happened this time hopefully.

The other thing is to hold a wad of kitchen roll on the area when you poo (sorry if TMI). The pour water over the area too. Also after that or weeing press super absorbent toilet paper rather than wiping so it soaks everything up. Just makes everything clean and dry.

I feel for you for me that was much worse than labour. I was told at the time that the body does not have the ability to remember pain - which helped. Just be kind to yourself and give it time. I had about 3 lots of ABs but it all healed in the end. After about 6 months I even wanted another baby

They wouldn't re stitch at this stage as this would just stitch the infection in and not help in the long run. The treatment would be antibiotics and keeping it clean. Although you are already on antibiotics you might need some different ones, a midwife can see you and advise you but she can't prescribe antibiotics so a gp is definately the one to see, they sound like they have been fobbing you off badly. Hope it heals well.

Oh jeebus no! The pain of everything else is nothing like as bad as my labour was. Very fast back to back, back labour that should have been over with in 4h, but lasted 7 (8 and a half with retained placenta), thanks to a failiure to do the last 3 pushes (head comes out, head goes in, head comes out, head goes in). Frankly, the rest of it was fine. I was begging for an eipdural once I got to hospital (about 90mins after waters broke) and was informed it was too late for anything bar pethidine and entonox...which was frankly useless for the 2nd time (was having contractions due to UTI at 31wks).
Whilst I don't wans DD to be an only child...to the point I talk about having another one, nothing in the world is going to make me have a natural labour again. Eipdurals all the way if I get my way (though I went from waters breaking to established labour in 10mins, so I also want to be induced).
For anyone else reading the thread with a similar problem...apparently it's not uncommon for things to heal "inside out", so whilst it looks 'open' it's healing well if it's not looking obviously angry and swollen.

maxbear is right that is the reason they don't consider a restitch at this stage. they may consider one at a later point should you need it. however 2cm can heal, and can heal fully- you should not be left with a half open wound for life and if it doesn't close up then you should think about restitching then. mine was 3inches- the whole thing fell open, not just partially like for some people- but it healed through a process of airing, salt baths, rest- and a series of cauterisations of 'granulation tissue'.

also i don't agree that the gp is the one for you tosee for ongoing treatment. definitely see them for the ABs and referrals, but the medics that will be most helpful to you are a; a gynaecologist and b; a tissue viability nurse (who is trained in wound care).

wishing you a speedy recovery.

Oeisha i'm 11 days PP and having the same problem it's so sore! I'm finding out if i've to get anti biotics tomoro. Can i ask how your healing and if your getting around ok yet? i've had one midwife tell me 6 weeks one tell me 3 weeks and one tell me 10 days, i've hardly left the house and getting stir crazy now!

kiki I've been fairly mobile throughout...mainly because not getting up and about would have driven me even more mental, so you have my sympathies. Not really sore anymore, and thanks to the stitches disolving it now feels a lot 'better' (I don't have the sore pulling quite so much). Just slightly uncomfy now...I think the ABs I was on has cleared up whatever the issue was...or the 'internal' bit of the stitches has finally disolved properly...
If you're not feeling more mobile yet, I'd be pushing for someone to take a look. Whilst you may not fully heal until 6weeks PP there shoudl be some improvement fairly quickly (I was told a week most before it felt like it was 'getting there'...which it initially did), it was only just before the stitches disolved I started to get the uncomfy/slightly wrong/more pulling feeling really.
I was told to hold off the salts and tea tree for 3 or 4 days, but then regularly bath in them. It really helped soothe...

I'm having good and bad days at the moment i can't really go anywhere as i'm still walking like a cowboy :( i has 2 cuts a second deg tear and 2 internal tears from forceps plus lots of internal bruising so i'm pretty beat up down there :( You've given me hope it will get better hopefully soon

Oh kiki. Take it one day at a time. Forceps can be brutal. I was lucky and didn't tear, just the episiotomy. Snufflix was OP and apparently that can make forceps 'easier'... It might be worth asking for a physio referal?

i have not 1 but 2 different types of infection!! wtf no wonder i was so sore! I now have 2 lots of AB to take a day making my daily tablets up to 16 not counting the up to 8 co codamol just fab!

at least you know what's wrong now...hopefully you can start to recover.