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Having a baby is exciting for all of us. New parents look forward to the first days of building a bond with their newborn baby. However, when a baby is delivered via caesarean section, the first few weeks for a new mom can be quite difficult due to the healing of the scar. Read what to pay attention to when healing a caesarean scar and how to properly care for it.
Caesarean scar – characteristics
A caesarean section is a procedure that involves intervening in the skin, abdominal wall, and the lower part of the uterus. If necessary, the fetal bladder is also pierced. On the other hand, when the baby and the placenta are pulled out, the doctor sutures all the damaged layers. This is how a cesarean scar appears. Most often it is about 10 – 15 cm. However, it can be bigger if the new mom is obese or if the baby is just big.
Types of incisions made during cesarean delivery
During a caesarean section, the doctor makes two incisions. The first incision is made through the skin of the lower abdomen, above the pubic hairline. A second incision is made in the uterus. There are two main types of incisions:
- horizontal – A transverse incision from below (or “bikini cut”) is now used in 95 percent of cesarean sections. This is because it takes place at the lowest part of the uterus which is thinner – meaning less bleeding.
- Vertical – Also called a “classic” caesarean section, it is a cut in the center of the abdomen, usually from the navel to the pubic hairline. Formerly this type of incision was very common, now it is usually reserved only in certain situations, including if you already have a scar from a previous cesarean section, if the baby is low in the uterus or in some other unusual position, or if there is an emergency that requires immediate delivery . Vertical cuts can be slightly more painful and take longer to heal than horizontal cuts.
See: Are post-cesarean adhesions dangerous?
Caesarean scar – disturbing symptoms
Usually, a cesarean scar (if you care for it, of course) heals properly without any undesirable symptoms. However, there are situations when there is:
- fever above (38 ° C),
- blood or pus coming out of the incision
- increased pain
- redness or swelling around the incision.
If you have any of these symptoms you should contact your doctor or midwife as soon as possible. The above ideas may indicate a developing infection. Treatment of such an infection may involve taking oral antibiotics or intravenous antibiotics, depending on the severity of the symptoms.
It’s also important to remember that although numbness at the incision site is normal, it usually goes away within a few weeks. If, on the other hand, this feeling continues for a long time and you experience shooting pain in your pelvis or down your legs, it may indicate damage to your peripheral nerves.
Cesarean scar removal – methods
Despite the fact that the cesarean scar has healed properly and you have no health problems with it, it may be an aesthetic problem for you. There are some methods that can make a scar less visible but not completely remove it.
Cesarean scar removal – non-surgical procedures
Non-surgical procedures used to remove a cesarean scar include:
- laser therapy – more and more women with a cesarean scar decide to eliminate it through laser treatments. It is considered to be one of the most effective methods of scar removal. Such a treatment consists in carrying out controlled skin microdamages that affect the process of tissue reconstruction, that is, to put it simply, old tissue is replaced with a new one,
- steroid injections – For more aggressive scars (those that have developed keloids or have become hypertrophic), injection of a long-acting steroid can reduce inflammation and help the cesarean scar flatten out and become less visible. Your doctor may inject a steroid into the site of the incision during your caesarean section to (hopefully) prevent hypertrophic or keloid scarring. If you decide to have steroid injections, after your cesarean surgery has been performed, the first injection can be given as soon as the scar has healed. You will need to receive injections monthly for three to six months, depending on the severity of the scar.
In the case of a cesarean scar, you can also try on special plasters, e.g. Sikatris Max silicone scar plaster or Sikatris plasters 5 × 30 cm.
Cesarean scar removal – surgical procedures
Since the appearance of the scar may improve, doctors generally do not make any repairs until six to 12 months after a cesarean section. If you’re still interested in surgical options, talk to your doctor about whether any of the options below can help you:
- scar correction – thanks to this procedure, the surgeon completely removes the skin around the scar, and then precisely sutures the new wound – leaving a thinner and less visible scar. Scar correction is especially helpful if the cesarean scar is wide or thick,
- tummy tuck – if you have excess loose skin on your abdomen after caesarean section, you may want to consider tummy tuck. During the procedure, the surgeon cuts off the unnecessary skin (including the caesarean scar) and carefully reattaches the incision.
Itchy cesarean scar
It is normal for a cesarean scar to heal during the healing process. However, be careful not to scratch the scar (especially the fresh scar) as this may lead to the development of an infection.
Itching can also be caused by your pubic hair growing back if it has been shaved just before surgery. If you still feel itchy after your pubic hair grows back, it could simply be because it is healing.
Read: Pubic symphysis
The exact healing process of a cesarean scar does not take two or three days, you need to remember this. You will notice that the area of the cesarean scar changes slowly. You can take photos to see what the healing process looks like over time. At first, the healing process is quite quick and you may notice daily changes, but after that, subtle changes may not be noticeable.
In fact, the time it takes for a cesarean scar to heal varies from woman to woman. Sometimes there are factors that slow down or hinder healing, such as poor nutrition or infection.
Since the cesarean incisions (as we already know) are usually made below the pubic hairline, you may not be able to see your cesarean scar at all. It will look red or pink for several months but will eventually fade to a pale flat thin line. As an alternative, you can use Fish collagen in a skin care gel to help reduce the appearance of scars.
Some women develop larger, thicker or raised scars than others – but they are rarely very visible. In fact, many of the bikini-clad women we see at the beach or swimming pool have cesarean scars, and we don’t even know it.
In more than 99% of cases of cesarean scars, it heals well and strong tissues are produced that reattach uterine tissue. It is almost always strong enough to withstand the stretching of the next pregnancy and the force of potential contractions. However, in very rare cases the scar may just come apart.
This is more common (but still rare) with vertical cuts than with horizontal cuts, which is one reason why vertical cuts are not made very often. If the cesarean scar becomes open, the uterus may rupture, causing heavy bleeding (haemorrhage) and is a life-threatening condition for both mother and baby.
Although uterine rupture is rare, many physicians and thus hospitals do not deliver VBAC after cesarean delivery.
Usually complications do not occur once the cesarean scar has healed properly. However, in some cases, a cesarean scar changes the way the placenta grows in the next pregnancy. The more a woman has had caesarean sections, the greater the risk.
Women who have a scar on their uterus are more likely to develop placenta previa, where the placenta grows above the cervix. In this case, it is not possible to safely give birth to a child via natural means.
In women after cesarean section, the so-called hypertrophied placenta may develop more often (in the next pregnancy). The placenta then grows through the scar tissue and / or attaches to the muscle of the uterus, which increases the risk of premature birth and bleeding during pregnancy. An overgrown placenta also makes it difficult for the placenta to separate from the uterine wall after the baby is born and can cause hemorrhage. In the rare event that doctors find it difficult to separate the placenta from the uterine wall, they need to remove it.
See: Due date – calculate when you will be born. Childbirth and the date of delivery
Basic rules of hygiene of the cesarean scar
A caesarean section can be a safe procedure, but it is still serious surgery, so it’s important to properly care for your scar to prevent injuries and infections. After the stitches are removed, the scar will be about 15 cm long. After removing the suture, it is recommended to care for the scar for another 3 days by washing it with disinfecting liquid twice a day (morning and evening). Also remember to:
- wear loose clothing – tight clothing can irritate the incision, so avoid tight jeans in the early postpartum period and choose pajamas, wide shirts, jogging pants, or other loose clothing. Such clothes allow air to circulate, which can speed up the healing process of the wound,
- give up physical activity – in the initial period, when the cesarean scar is quite fresh, give up physical activity. Wait until the end of the puerperium (6 weeks). Let the doctor decide when you can take up physical activity,
- if it hurts a lot, take painkillers – Over-the-counter pain medications can also relieve pain after a caesarean section.
On a healed scar, it is worth applying NoScar® Scar Cream, which will brighten, smooth and accelerate the healing of the scar.
Unfortunately, the caesarean section wound does not always heal properly (as we already know).
A wound that comes in contact with bacteria or other harmful microbes can cause certain types of infection, such as cellulitis or urinary tract infections.
Staphylococcus bacteria are the most common cause of infection in wounds after cesarean section. Staphylococcus bacteria naturally live on human hair and skin. When they multiply and get into a wound, they can cause several types of infections.
Wound infections usually appear after 4-7 days. When symptoms appear within 24 hours, Streptococcus or streptococcus could be the cause.