Suture reactions are uncommon, but tend to happen more with chromic than synthetic suture. A reaction may produce abscesses and a whitish discharge from the area. This does not necessarily indicate an infection, just excessive inflammation (white blood cell activity), due to the reaction. The sutures in the immediate area may come undone, or the whole repair may break down. When gut material has been used, this is reported as stitches falling out about 4 days postpartum. Gut materials produce more inflammation in general, and the increased enzyme reaction from the allergy causes it to break down more rapidly.

To differentiate a suture reaction from an anesthetic reaction, rub a cotton swab soaked in anesthetic on the inner cheek. If any reaction other than numbness (such as itching) occurs, you probably have an anesthetic reaction. If this test is negative, you may have a suture reaction or infection (this test is not 100% reliable). Anesthetic and suture reactions may be accompanied by tenderness, swelling, and irritation (however, significant redness may also indicate an infection is present).

An allergic reaction to iodine-based antiseptic solutions may also result in local redness, swelling and irritation. A very few hypersensitive women may even react to your wearing latex exam gloves. If a woman is highly allergic to latex, using vinyl gloves would probably be the best alternative. If a woman knows she is extremely environmentally sensitive, perhaps she can order gloves to have on hand for you at the birth.

Treating allergic reactions:

In any case, hot Rosemary infusion sitz baths three times daily will help relieve the discomfort and resolve the problem. When inflammation is apparent freely irrigate the area with with normal saline solution (1 tsp. salt to 1 quart water) or Ringer's lactate twice daily before bathing for the first 24 hours. It will help carry away dead cells. Otherwise, care for the area as suggested in the chapter on General Care and Comfort Measures.

Be sure the client understands that she had an allergic reaction and to what she reacted, so that she can inform future care providers.