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Perineotomy Region
Description
Many germs inhabit the surrounding perineotomy region, but childbirth wounds can heal quickly without medical intervention.
Unless infection and hematoma are present, the perineotomy region (i.e., perineum, the space between anus and the vulva) requires only a sitz (hip) bath to heal.
Pain
As the perineotomy region heals, tightening pain will continue for 2-3 days after birth and make walking and sitting uncomfortable. But the pain should ease by the time the stitches are removed.
In the United States and other countries, an anesthetic spray is administered to reduce pain; in Korea, however, hospitals and physicians administer painkillers.
The pain itself can be from the perineotomy, but if the pain is severe, complications such as necrotizing fasciitis should be considered.
Inflammation
If there is inflammation in the surrounding tissue, the stitching may look clean but the surrounding area will be reddish, swollen, warm, and painful to touch.
This must be treated quickly with an antibiotic, because the inflammation could spread or the wound could open.
If the wound tears a little and the inflammation disappears, it will heal. However, if a considerable tear exists, it will need antibiotics, sitz baths, and a second stitching once the inflammation has been treated, in order to heal properly.
Scars
There is almost no scarring if the perineotomy is performed vertically, from the vagina to the anus, because it matches the grain of the tissue.
The perineotomy incision is made at a 45-degree angle if an anal laceration is a concern. This leaves a little scar tissue that does not usually affect a patient's quality of life.
Large scars that spread in multiple directions are aesthetically unpleasing and can cause pain during sex. Most scars can be removed or made more aesthetically pleasing with plastic surgery.
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