Episiotomy stitches have failed... anyone experienced this and got advice???

[ElmMum]

So, gave birth on the 12th (12 days ago). Had episiotomy. Stitches all felt fine for first couple of days, then around day 3 or 4 really starting stinging and hurting.

First midwife who came round said stitches very loose but okay. Second midwife took a swab. Third midwife said top layer of stitches are gone, wound is open (muscle layer is still stitched but skin is open) and anarobes found in swab.

So now I'm on antibiotics and midwife says they won't put more stitches in. Just have to wait for antibiotics to start working and the wound will have to heal from the inside out. Could take up to 6 weeks.

They've made me an appointment for 9 days time at the hosp for a doc to check if it's healing okay. Midwife came again today and said it looks the same as it did on Wednesday, so no improvement.

She says if it doesn't heal I'll have to have an op to sort it out.

So, I suppose I just want to know if anyone else has had this and whether the advice I'm being given sounds right. I kind of feel like, why can't they just put some stitches in?? Would make things a lot more comfortable for me.

Plus they keep contradicting themselves. First two midwives said dip into a shallow bath twice a day to keep things clean. Most recent midwife said don't bath, it might swill bacteria back into wound. Have showers instead.

Agh, I feel really fed up with it all. It's painful and I'm having to sit on it for hours while feeding DD2. Is spoiling what should be a lovely time. Any advice?

Oh, you poor thing! I'm so sorry to read that this has happened and that you're being told all this conflicting info to boot.

I had an episiotomy with DD1 in 2009 but thankfully, no issues with infection with the cut. All of what I'm going to say, therefore, is based solely on my opinions, what worked for me and not proven medical advice.

For my recovery, I made sure that I bathed twice a day for about 2 weeks in salt water (about 2 table spoons per bath), soaking for 10-15 mins. I think the point of salt water is to dry things out, making the area less appealing to bacteria. My Mom is an old-fashioned, old-school nurse (1970s era) and she looked after me with this. I think that the use of salt water is frowned upon by many for wound healing now, but I think that it aided me recovery. I was meticulous with personal hygiene, too: washig my hands before as well as after using the toilet. I frequently changed my pants; I changed my pad every time after going to the loo.

I guess that you can't have more stitches in because your perineal tissue is infected and wouldn't be able to hold stitches at the moment. I would think then, that it is IMPERATIVE to get that tissue to heal. Could you aside stronger antibiotics?

In terms of making you more comfy when feeding your baby, maybe get one of those cushions with a hole in (for haemmorhoids) for now. I don't know where they're sold but Boots might be a good place to try, or ask your Dr or midwife.

I sincerely hope that you get sorted out very soon. Best of luck and congratulations on your new baby xx

'ask for' not 'aside' bloody corrective text

I covered with a pad when I went to wee. I never had an infection. But was a bit when the midwife told me she having a discussion with the other midwives. I've been told by DP that it doesn't feel any different.

Yep. This happened to me. had my LO in sept, a few days after I felt like every time I stood up I was tearing. Turns out what was happening was the wound was starting to knit together when I was still then as soon as I stood it opened again. Was gaping about 2 cm from what I recall.

They won't restitch it because the skin will have already started to heal and so they won't knit together, and they said that it would heal up well enough without.

I had salt baths, shallow water, oodles of salt in it. Sat on rubber rings, pillows angled so there was no pressure on the area. I remember it being the worst part of the whole new baby experience.

I had antibiotics for a poss infection too.

6 months down the line all things are fine.

I hope it starts to feel better soon.

Oh. Congratulations on your new arrival btw.

And I used thick maternity pads for longer than I needed for extra comfort.

Lunar - thanks for your reply. I think if the stitches were still in a salty bath would be great, but probably just too painful with an open wound! I think I'm going to stick to showers as advised by the most recent midwife, to avoid bacteria getting in while sitting in bath. Oh, and I've hired a valley cushion from NCT which is a total lifesaver. Can't actually sit down without it.

100 - poor you, all sounds very familiar. Really glad to know you're all better. Gives me some hope. Can you remember how long it took for the wound to close up? I feel like it's never going to be better because I'm sitting on it constantly feeding DD.

I had an episiotomy and the warm salt water actually made the pain much more bearable. I am a great believer in warm salt water to cure most things. It sorted out infected stitches in an op wound where antibiotics failed.

Hi OP. This happened to me. Rather about some of the advice you are getting on here although not entirely suprised as initially it was the advice I was given also.

Let me tell you what the consultant told me to do with regard to hygiene. No bathing - this can soften the wound and stop it healing, no salt water, tea tree oil any of that kind of thing. Shower and pat dry, try to keep as dry as possible and let the air get to the wound. Do not dry wound with a hairdryer this can spread the infection. This advice was very different to what I had from the midwife, but it worked.

With regard to what happened to me - my episiotomy got infected, opened up, but I'm not sure how far (possibly more open that yours?). I was re-admitted to hospital and had some tissue removed and a restitch under GA. I couldn't sit down on it at all, it was complete agony. The restitch was the best thing that could have happened although all this did leave me with continence issues.

May be worth seeking another opinion/being a bit forceful if you are not happy with the current outcome?

Elm, the wound didn't close up together, as in the two top bits of the cut didn't close fully, but it did heal up well. I think between 5 and 12 days were the worst days for me(trying to think back), then it got better day by day. From what I recall I think at about a month it felt OK everyday, as I had a few good days and bad days off and on dependent on how active I had been.

RufousBartleby did you actually read my post? I was simply informing the OP about what worked for me, and stated this from the beginning. Granted, many consultants do not favour salt baths as current practice as trends change within medicine, but my own mother, who is an experienced, senior nurse practitioner, has treated many wounds over the years with this method. Please bear in mind that, although not necesserily current practice, certain methods work for some people, depending on their issues.

That is all, I'm not going to co-hijack this thread with an argument. I wish everyone good health and healthy, happy babies!

Thanks for all the info, everyone. (No need to have a row about anything!)

My gut instinct says no more baths. Just showers from now on, keep it as dry as possible and lots of pelvic floor exercises to get blood flowing to the right area. If there was time in the day to give my undercarriage an airing, I would, but with a 3.5 DD1 and a constantly feeding DD2, there really isn't an opportunity.

I do wonder whether if they'd checked my stitches before I was discharged from the hospital they would have seen they were loose and been able to do something before it went too far. I know there's no point in thinking like that but it is so frustrating when I know if the stitches had held I'd be well on my way to recovery by now.

sigh

My experience

My third degree tear started to gape so following the MW advice I started bathing in salt water twice a day, the salt helps to dry the wound out. Every single person I have spoken to about this advocated bathing in salt water from the Drs, MWs to my DM, my MIL and both SILs.

Two courses of antibiotics did the trick on the infection and 8 weeks down the line, things are much better. Still tight when having sex but that's it.

The salt water thing is just that professional's personal preference (and probably what they've been telling women for eons!). There was some good research into this which showed that adding salt, witch hazel or anything else to water had no effect on healing. But it doesn't have a detrimental effect either.

OP hope you are feeling better soon. FWIW there is likely nothing they could have done had they spotted this problem before you were discharged. Once you've been sutured, it can't be redone unfortunately :( Sorry this happened to you.

In terms of the consultants point maybe its a good idea not to stay in the bath too long?