Why is the episiotomy wound getting more and more painful?

The episiotomy is a minor surgery that women often need to undergo when they are about to give birth. If the recovery from such a minor surgery is not good, it will be very detrimental to the body's recovery after childbirth. It can easily lead to infection and cause swelling and pain. Therefore, it is necessary to adjust the wound in time. If the pain becomes more and more after the episiotomy, you should be alert to the signs of hematoma and receive appropriate treatment in time.

Why is the episiotomy wound getting more and more painful?

Most primiparas undergo an episiotomy during vaginal delivery and leave a wound. The perineum area has loose tissues, rich blood vessels and nerves, and is extremely sensitive to pain. Therefore, perineal wound pain becomes a common symptom among parturients. The main types of pain are:

1. Traumatic pain. Skin and muscle cutting, nerve separation and rupture, coupled with suturing and ligation, will usually cause varying degrees of wound pain, which is a normal phenomenon. The pain was severe on the day of surgery and was significantly relieved after two or three days. If the pain is more severe, you can take some painkillers, Kefulan or insert anti-inflammatory suppositories into the anus.

2. Edema pain. Wound edema is more common in those with a longer second stage of labor. At this time, the sutures on the wound are tightened and the pain continues. The mother can apply 95% alcohol gauze to the wound or expose it to infrared rays, which will help the edema subside and the pain will disappear.

3. Hematoma pain. This is pain caused by internal bleeding from the wound. Bleeding accumulates in the wound to form a birth canal hematoma, and the skin around the incision is bruised, purple, swollen and hard, and obviously tender. When the amount of bleeding is large, the hematoma may spread up and down the incision, and in severe cases, shock may occur. At this time, emergency hemostasis should be performed immediately, the sutures on the wound should be removed, the accumulated blood should be cleared, the bleeding points should be sutured, and the wound should be re-sutured.

4. Infectious pain. The incision site is red, swollen, painful and hot, accompanied by fever throughout the body. This is usually the early stage of inflammation, and anti-inflammatory treatment should be given in a timely manner, supplemented by local heat therapy. Inflammation can usually be controlled, and pain will be reduced or even disappear. If the wound becomes festered, the sutures should be removed and the wound opened for drainage, and secondary suture can be considered after the inflammation is eliminated.

5. Pain caused by unabsorbed intestinal thread. This situation is common after discharge from the hospital. The wound scar is slightly raised, ulcerated and pus is oozing out, and intestinal threads are protruding. Usually, the tear will heal on its own after the intestinal thread is discharged. At this time, you can use 1:5000 potassium permanganate solution or Jieryin or Dilox liquid to wet the affected area for 10 minutes each time, and then apply erythromycin ointment topically, twice a day.

6. Induration pain. The incision causes fibrous tissue hyperplasia and forms a nodule due to inflammation, unabsorbed sutures, etc. At this time, local physical therapy should be the main treatment, such as infrared irradiation, or hot water sitting bath, 15 to 30 minutes each time, twice a day. In addition, intramuscular injection of placental tissue fluid or chymotrypsin can also help soften and dissipate nodules.

How to care after episiotomy

First of all, keep the vulva clean. From the second day after delivery, rinse the vulva with 10% Cleanse Yin liquid, or scrub the vulva with 10% Cleanse Yin twice a day until the stitches are removed. If you feel swelling or pain in the vulvar wound, seek medical attention immediately. Generally, you can use 95% alcohol gauze wet compress or 50% magnesium sulfate hot compress.

Secondly, keep urination and defecation unobstructed, and rinse the vulva and anus after defecation. Change sanitary pads and underwear frequently.

In addition, when sleeping or lying in bed, it is best to lie on the side without the perineal wound to reduce the chance of lochia flowing into the perineal wound.

The dietary care for women who have undergone episiotomy is roughly the same as that for general women.

Knowing the cause of the pain, you can prescribe the right medicine. Mothers should remember to pay attention to the cause of their wound pain.