Stitches or sutures act as a closure for either surface wounds or deep wounds. Procedure to close a deep wound comprises of sewing the two edges and applying stitches under the skin surface.

Catagories of sutures

    Non-absorbable stitches: Such stitches are applied in case of skin wounds or internal wounds. Such stitches get healed quickly and are easy to remove. Non-absorbable stitches are made of natural fibers or synthetic threads like nylon polypropylene. As the name suggests, these stitches are either permanent or persist for a long time.
    Absorbable stitches: Such stitches are applied on layers, which have the property of healing quickly. They are very firm during the initial days. Then they start getting dissolved in the body.

Precautions taken by medical team before applying stitches to prevent infection

    Careful checking of nose for occurrence of germs before the start of operation.
    Skin must be cleansed prior to surgery.
    Sanitizing hands prior conducting the surgery.
    Usage of germ free gloves and sterile clothes while applying sutures.
    Prescribing antibiotics to the patients who may fear high risk of infection.

Precautions to be taken by patient to prevent infection

    Take a bath prior to surgery.
    Avoid using razor at the surgical site. The same can be carried out by using clippers by the surgery team itself.
    Keep all your jewellery aside before the operation starts. Do not apply nail polish.
    It is advised to cover up the wound. Try to keep the adjacent areas germ free. This is a crucial step in avoiding infection.
    Visit your doctor at once on finding redness around the wound.

When to see the doctor
Pain up to a certain threshold is normal. In case pain gets unbearable, the scene can be alarming. It may be an indication of infection. Taking immediate remedial steps is necessary to avoid infection or any other side effects post the surgery. On meeting with any of the following signs, it is better to consult doctor at once.

    If the skin around the wound gets swollen.
    If you detect redness around the wound.
    If the pain becomes unbearable.
    If the wound starts developing pus.
    If your body temperature increases abnormally or if you have fever.
    If you observe red streaks around the wound.
    If in case a stitch gets opened up and the edges of the suture start widening. This is the most alarming sign. In case a suture gets opened, you must immediately seek a remedy.

Ask your doctor for the precautions you can take to avoid experiencing any of the above signs. If you come across such alarming symptoms, rush to the nearest hospital and get the appropriate treatment.

Pain in Stiches - When You Should See Your Doctor?

In preparation for the possibility of conception, a woman's body undergoes the menstrual cycle every month which culminates into the periods. This is a normal process which all women of reproductive age go through every month. However, in certain cases, the periods can be really painful where you may suffer from menstrual cramps or could be generally in much pain. This condition is known as Dysmenorrhea.

What exactly is Dysmenorrhea
As mentioned above, Dysmenorrhea is a disorder that many women got through while having their periods where they may suffer from painful cramps. The pain usually occurs in the pelvis area along with the lower abdomen and it may also be accompanied by other symptoms.

Some symptoms of Dysmenorrhea
Some of the symptoms of Dysmenorrhea could be any combination of the following factors
I. Very painful menstrual cramps accompanied by lower back pain
II. Diarrhea and nausea along with the cramps
III. Pain in the inner thighs, lower back and hips
IV. Being hypersensitive to light, loud sounds, specific smells and touch
V. Being fatigued all the time, even causing you to faint

Causes of Dysmenorrhea
Dysmenorrhea is usually caused by the contraction of the Uterus. While the uterus does contract a little even in normal periods, during Dysmenorrhea the contractions tend to be a little too much. Due to this the uterus presses against the blood vessels and organs within the vicinity causing oxygen loss to them. This causes elevated levels of pain and discomfort.

Some of the underlying causes which may result in Dysmenorrhea are:
1. Narrowing of the cervix - Also known as stenosis, the lower part of the uterus which is the cervix may become narrow due to scarring and cause Dysmenorrhea.
2. Endometriosis - This is where the uterine lining is found outside the uterus, especially in the pelvic cavity and thus may cause painful cramps.
3. Inflammatory pelvic diseases - This is when a bacterial infection in the pelvic area can spread to multiple organs, including the uterus and thus may cause painful menstrual cramps.
4. Tumors - Tumors or fibroids which are unwanted growths on the inside of the uterus may also trigger Dysmenorrhea.

What to do if you are suffering from Dysmenorrhea
Below are some of the basic steps which you can take to ease pain from Dysmenorrhea
1. Avoid smoking and abstain from alcohol
2. Ample rest during periods
3. Keep the body dehydrated
4. Don't consume foods high in salt
5. Don't drink coffee or any caffeine rich foods
6. Lower back massages and hot water bag treatments to relieve pain
If severe pain still persists for long or if dysmenorrhea occurs repeatedly, then you should consult a doctor first rather than trying to resolve the problem yourself.


All about Dysmenorrhea

Problems with the arteries and veins present in the hands or legs can lead to vascular disorders. The arteries carry blood from the heart to other parts of the body in order to deliver nutrients and oxygen. The veins carry the blood back to the heart, after the nutrients have been used up. If these blood vessels of the arteries or veins become blocked or narrowed, it can lead to a vascular blockage.

A vascular blockage that occurs in the hands or legs comes under the category of Peripheral Artery Disease or PAD. These type of disorders are less common in the upper extremities of the arms or hands than in the lower extremities of legs. Few of the signs for the same are:

Pain and difficulty in movement due to decreased blood flow
Numbness or weakness of leg or fingertips
Sores on the toes or feet
If the blockage is deep, symptoms of redness, swelling, extreme pain or cramping can be experienced
Abnormal color changes in the fingertips
Ulcers or wounds that don t heal
Skin sensitivity problems when in cold temperatures
How can it be diagnosed?
The blockage can be detected by various methods namely-

Physical Examination   Your doctor may find decreased pulse at armpit, wrist or fingers, full veins, masses, wounds or gangrene.
Doppler or Ultrasound examination to determine the blood flow in the arteries and veins
MRI Scan of the affected area to pay special attention to the blood vessels
Cold Stress Test
Arteriography to show clear blood vessel details
Angiography to map blockages and narrowing of the arteries
What are the Risk Factors for Peripheral Artery Disease?
An individual is at risk for developing vascular blockages in the hands or legs if one or more of the following factors are present:

Smoking
Diabetes
Heredity Factors   A personal or family history of blood vessel disease
High blood pressure
High cholesterol
Aging   People aged above 50 years and older are more prone to vascular blockage
Can it be treated?
Treatments for vascular blockage can vary depending on the age, cause of the blockage, intensity and overall well-being.

Treatments can include:

Self-care   Reducing risk factors and making lifestyle changes to quit smoking, sedentary life or diabetes, blood pressure and cholesterol management can reverse symptoms of vascular disease.
Medications   A variety of drugs can be prescribed to lower the risk and progression of narrowing blood vessels or prevent blood clotting.
Interventional Procedures   Minimally invasive surgery like saloon angioplasty, stenting or removal of artery plaque build-up.
Surgery   If the blockage is severe, surgery may be performed to lessen the vessel narrowing, reconstruct the artery or tie it off, depending on the circumstances.

Pain in the Hands or Legs!

Leg bypass surgery is needed when the patient suffers from peripheral artery disease. PAD is a very common condition in elderly people, where the rate of flow of blood to the limbs (in this case, the legs) is reduced due to narrowing of the blood vessels.

Causes and risk factors-

The narrowing of the blood vessels occurs due to excess calcium accumulation and fat deposits in the walls of the arteries. The following are the risk factors of PAD-

  Age (60 years and above)
  Smoking
  Diabetes

The condition may be life-long or can last for years.

Symptoms that indicate you might need a leg bypass surgery-

The following are the signs and symptoms of PAD, which suggest you should consider having a leg bypass surgery-

  Pain in the legs, especially when walking
  Pain in the buttocks
  A sore on a foot/leg that does not seem to heal
  Thinning of the skin on the legs
  Loss of hair on the legs
  Tingling, weakness, or numbness in the legs
  One or both the feet/legs may feel cold
  The feet or legs may appear bluish, pale, or dark reddish in colour

You should get yourself checked by a specialist in the initial stage, or else the condition may get worse and affect your day-to-day activities.

Vascular surgery for PAD in the legs:

Vascular surgery is a surgical sub-specialty, which manages vascular system disorders- disorders of the veins, arteries, and lymphatic circulation- by surgical reconstructions, minimally invasive procedures, and medical therapies.

The most commonly used surgical procedure is the leg bypass surgery. The surgery aims to reroute the supply of blood around an obstructed artery in one of the legs.

How is leg bypass surgery performed?

The surgeon performs leg bypass surgery using a graft (usually made of plastic tube) to bypass or replace the blocked portion of the artery. On some occasions, the graft may be a vein or blood vessel taken from the patient s body (usually, the other leg).

During the surgery, the surgeon will first administer anaesthesia so that you are not able to feel pain or discomfort. He/she will make an incision over the portion of the blocked artery. After carefully removing the skin tissues, the surgeon will place clamps on each side of the narrowed artery and sew the grafts in place. The surgeon will ensure that the flow of blood in your lower extremity (legs) is good. An arteriogram (an X-ray of the arteries/blood vessels) is recommended to make sure that the graft is working fine after the leg bypass surgery.

For most people, leg bypass surgery helps improve the flow of blood in the arteries. The prognosis is better if underlying medical conditions like diabetes are controlled.

Leg Bypass - Treating It Through Vascular Surgery!

Vertebroplasty means shaping the backbone i.e. vertebra for backbone and plasty is related to shape. This is an outpatient procedure done to treat compression fractures of the spinal cord. The backbone is made up of multiple small bones which are stacked one on top of the other with a filling material in between that is known as vertebrae. The stack of bones are held in place by the soft, elastic vertebral material. 

Vertebroplasty & similar procedure called kyphoplasty is a non-surgical procedure where collapsed vertebrae is brought back to shape by injecting medical bone cement under fluroscopy / image intensifier in OT, thereby relieving pressure on the spinal cord or spinal nerves with special canula directed to the core of vertebral body. Indicated in osteoporotic vertebrae, spinal fracture, metastatic tumour or primary tumour of spine. This technique has replaced major surgery done earlier to reshape & fix vertabrae.

Technique: Bone cement, in a semisolid state, is injected into the weakened or fractured bone space. Once this solidifies, it provides additional support to the spine, enabling normal movement. It also helps in reducing the pain significantly and improves the overall mobility.

Procedure:

In what takes about an hour, the following steps are done. Earlier, a few decades ago, this would be an open surgical procedure. However, with advance technology, now it is done using a small incision

Local anesthesia is given in the area that needs to be operated
A biopsy needle is inserted into the fractured space with the help of an X-ray
The acrylic bone cement is injected into the bone space with a needle to fill up the space, once it solidifies, it stabilizes the vertebral space
The needle is removed and the incision is covered with a bandage
Usually the patient is sent home in an hour s time unless the overall condition is really bad
There could be some soreness at the site where injection is given, but one can notice a significant reduction in pain from the day of the procedure
There is also improvement in mobility while doing daily chores
The pain relief can last up to 3 years after the procedure
Returning back to normal activities takes about 3 to 4 days after the procedure
When to use this procedure?

Vertebroplasty is usually done in case of non-radicular pain that is intractable. In most cases, they do not respond to traditional therapies including physiotherapy, pain medications and even surgery. The pain could be due to:

Osteoporosis
Cancer metastasis
Myeloma
Spinal hemangiomas
Traumatic fractures
Benefits of using vertebroplasty for managing pain 

Minimally invasive
Effective way to get relief
Improves mobility
Cost-effective
Reduces need for long-term use of painkillers
Stabilizes the spine and prevents further collapse

Vertebroplasty - How It Can Help Manage Pain?

Lower abdomen pain can originate from a range of medical issues. In some cases, the pain disappears just like the way it came, in some cases, it takes longer medical treatment to cure the pain. Once the origin and the root cause of the pain are diagnosed, there are plenty of medical options to cure the pain. In this piece, we will briefly touch upon the causes of lower abdomen pain:

Appendicitis: This is one of the most common causes of lower abdomen pain. It typically originates from the right side of the stomach and soon diverges into the other side as well. The pain can become unbearable in a matter of hours.
Pelvic inflammatory disease: This is an infection that is caused in the reproductive system of a woman. This is often characterized by vaginal discharge, fever, weakness, intercourse related pain and pain in the lower abdomen.
Miscarriage: In case there is a loss of fetus on or before the twentieth week, the mishap is termed as miscarriage. It results in acute pain in the lower abdomen pain, vaginal bleeding, back pain, fluid expulsion from the vagina etc.
Fibroids: This is a growth in the uterus that is often non-cancerous and is commonly characterized by symptoms such as heavy periods, constipation, pain in the legs and back area, pain in the lower abdomen area, frequent urination etc.
Cancer: A cancerous growth in the lower abdomen area can lead to very sharp pain in the back and surrounding area. The pain is dull in nature and slowly spreads to other areas in a short interval of time.
Cholecystitis: This is a disorder that results in swelling of the gallbladder area. It results in a sharp pain in the lower abdomen area. A doctor needs to be immediately consulted if a person is suffering from this disease.
Intestinal obstruction: When the lower bowl gets blocked due to the contents of the lower intestine, a person can feel a sharp pain in the lower abdomen area.
Salpingitis: When a woman faces stiff pain in the lower abdomen area due to an inflammation of the fallopian tube, Salpingitis is the culprit behind it. This is a sexual disease and needs a doctor s consultation to get rid of it.
PMS: A woman can face throbbing pain in the lower abdomen area during her monthly periods. Other symptoms include cramps, weakness, fatigue etc.
Endometriosis: When there is an extension of the uterus tissue just outside the wall of the uterus, it leads to symptoms such as lower abdomen pain, cramps etc.
Polycystic ovarian syndrome: This is a disorder of the hormone and can lead to symptoms such as heavy periods, a growth of facial hair accompanied with sharp pain the lower abdomen area.

Pain In Lower Abdomen - What Could Be The Causes?

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