# Unstitched tears and healing



## lc81002 (May 2, 2005)

With my first birth (home water birth), I had a 2nd degree perineal tear that was pretty much like a "natural episiotomy." My midwife told me that I could leave it alone, get it sutured, or she could use Dermabond on it. I didn't want to leave it, but also didn't want to get a shot and stitches, so I opted for the Dermabond. It actually worked well, but I popped the skin back open at 3 weeks PP because I strained too hard going to the bathroom (PP hormones totally mess up my digestive system, I've learned...). Instead of healing back together, I ended up getting a skin tag kind of thing and at 3 months PP I finally asked my midwife to cut it off, and she put in 1 stitch to keep everything together. The numbing shots didn't do diddly squat and it was horrible, but I did finally heal after that. A year ago, when my son was almost 2, I kept feeling something pinching, and I finally looked in the mirror and saw that my stitch had never dissolved or fallen out, so I had to have it removed, and that was unpleasant as well.

Since my "not that bad" tear last time ended up being pretty complicated to heal from, I was really hoping not to tear again with my second (another home water birth), but unfortunately I did tear - basically right along the scar from last time, so it was a 2nd degree "natural episiotomy" again. I saw a different midwife this time, and she said she only sutures bad tears, and mine was "not that bad," so she would leave mine alone and it should heal by itself, as long as I kept my legs together for a few weeks. I'm right around a month PP now and the muscle healed after a week or so, but I can see that my skin is still gaping open around it. Will it ever grow back together on its own at this point? I'm thinking my body is just bad at healing down there and I'll have to get re-cut and sewn to get it fixed. The thought of that terrifies me, knowing how poorly local anesthetics work on me and how much the repair hurt at 3 months PP last time. I doubt they would put me under for something so simple, but I would prefer it if I have to go that route. I'm also concerned about insurance not covering it since it's "cosmetic," even though I have an open wound.

Ugh, next time I am insisting on sutures right after the birth, even if my tear is "not that bad" again. This sucks.


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## SaraLe6 (Mar 4, 2009)

I'm 7 week PP with a 1st degree tear that seems to have healed open. It's also retorn several times during bowel movements. However it is still healing WAY better than the first degree tear I had stitched with my first son. It took 9 months for the pain from the stitched tear to go away, whereas the pain from this one is almost gone even though it healed open. I'd prefer to be a little looser than to wait 9 months to heal again.


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## lc81002 (May 2, 2005)

I haven't had much pain since the muscle healed, but it does sting a bit after a BM. It doesn't bleed with every BM like my tear from my first birth did (after I split it back open), though. I'd be afraid of the stitches being "tight," but I did heal quickly once I got snipped and stitched last time. It was just the one stitch. My scar was always kind of stiff and a bit tender, though. I don't know if that has to do with how it was repaired, or if that's just how my body heals. I don't think I had nearly as much exposed muscle tissue last time as I do this time, though. That kind of freaks me out a bit. I can't imagine having sex (not that I even want to right now, ha) or going for a pap smear or anything with the muscle exposed like that.


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## lc81002 (May 2, 2005)

Anybody else have any ideas?


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## ursusarctos (Dec 16, 2008)

I recently read this article on Midwifery Today about using seaweed in the place of sutures: http://www.midwiferytoday.com/articles/suturing.asp
Don't know how different that would be from the dermabond though.
Have you tried comfrey infusion sitz baths/compresses?


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## liberal_chick (May 22, 2005)

I totally could've written this OP! I had my dh check my healing progress last night b/c we want to DTD and he said it is still wide open. I'm totally freaked out! If I need to go get stitches, I want to go ASAP.


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## lc81002 (May 2, 2005)

Quote:


Originally Posted by *ursusarctos* 
I recently read this article on Midwifery Today about using seaweed in the place of sutures: http://www.midwiferytoday.com/articles/suturing.asp
Don't know how different that would be from the dermabond though.
Have you tried comfrey infusion sitz baths/compresses?

I don't know if the seaweed would do anything at this point since it's not a fresh wound. The edges of the skin have healed, so I would think there's nothing there to grow back together, even if the skin is brought back together. I'm just wondering if skin will eventually grow over the exposed muscle if I wait long enough, or if it's just going to stay like it is without being re-cut so it will heal back together instead of open.

I did do herbal sitz baths with comfrey, but I don't see what good they will do at this point, other than being soothing to the tissue that is exposed and a bit tender.


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## lc81002 (May 2, 2005)

Quote:


Originally Posted by *liberal_chick* 
I totally could've written this OP! I had my dh check my healing progress last night b/c we want to DTD and he said it is still wide open. I'm totally freaked out! If I need to go get stitches, I want to go ASAP.

After last time, I'm terrified of getting stitches, but if I am not going to heal until that happens, I guess I need to just suck it up and do it.


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## ursusarctos (Dec 16, 2008)

Quote:


Originally Posted by *lc81002* 
I don't know if the seaweed would do anything at this point since it's not a fresh wound. The edges of the skin have healed, so I would think there's nothing there to grow back together, even if the skin is brought back together. I'm just wondering if skin will eventually grow over the exposed muscle if I wait long enough, or if it's just going to stay like it is without being re-cut so it will heal back together instead of open.

I did do herbal sitz baths with comfrey, but I don't see what good they will do at this point, other than being soothing to the tissue that is exposed and a bit tender.

Oh right, sorry. I was thinking along the lines of possible future tears.
Comfrey is tissue-healing and building, so I would think it would be good for skin regeneration too... you can also take it internally, according to Susun Weed.
In any case I hope you find a way to heal your poor perineum soon!


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## lc81002 (May 2, 2005)

Well, it's hard to find the time to do the sitz baths now, with my husband working all the time and being home with 2 little ones, but if I have time I will give it a shot. I'll see if I can get some comfrey to take internally too - would it be a tincture, or capsules or what?


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## ursusarctos (Dec 16, 2008)

Susun Weed recommends comfrey to be taken as an infusion internally. 1 part dry herb to 4 parts boiling water, cover and steep for 4-8 hours or just overnight. When I make an infusion, I generally use 2 cups water and 1/2 cup herb and sip the infusion over the next day.


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## lc81002 (May 2, 2005)

Hmm, I don't know if I could stomach that. I looked at my tube of calendula cream last night and saw that it does have comfrey in it. I've been using that pretty regularly. I might just give the seaweed a try. It can't hurt anything, I suppose. It's the sheets you can buy for making sushi, right?


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## cyclamen (Jul 10, 2005)

No, that will be really messy. Get "wakame" or some other whole seaweed, and soak it in water to reconstitute, just not konbu, it's too thick to use.

if you do get nori, just know it will dissolve into little flakes after a while


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## lc81002 (May 2, 2005)

Ok, thanks for the info. I will have to see what I can find.


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