How to properly handle a caesarean section. Possible complications in the healing process

The biggest fear of a future mother who is scheduled for a caesarean section is an ugly seam that spoils a woman’s flat stomach. And after the operation, many ladies are horrified by the burgundy scar on their stomach, thinking that the seam will remain so. But it is worth reassuring future women in labor, the scar after a cesarean section will become less noticeable every day, and over time it will turn into a thin pink stripe. And, if there is concern about a non-aesthetic appearance on the beach, then there will be no trace at all behind panties with a high waist.

However, on different types of skin, the operation leaves different scars, for many, of course, a thin imperceptible line remains, but, unfortunately, in some women, a caesarean section “gives” a compacted scar. Everyone is individual, and all stages and healing time are different for everyone.

Types of scars and stages of their healing

There are two types of sutures after a cesarean section, which the woman in labor will have depends on the complexity of childbirth, the position of the fetus, and so on:

Transverse. Usually such an incision is made during a planned operation, it passes over the pubis. The healing period of such a seam lasts no more than three weeks, then a barely noticeable trace remains, which is easy to cover even with bikini panties.
Longitudinal. More often it is done with an emergency section, when the life of the mother and baby is more important than the aesthetic appearance. The abdomen is cut from the navel to the pubis, unfortunately, such a scar is more noticeable and has the ability to increase over time.

Experts believe that a scar after a caesarean section heals in three stages:

The initial stage is about a week, after which the primary scar is formed. The seam is bright red or burgundy, with clearly defined edges, threads are visible. Perhaps the movements cause severe pain, the postoperative scar is still sore.
At the second stage, the scar begins to thicken, changes its color to a less bright one. It still hurts, but the sensations are no longer as painful as the first week. This stage lasts up to a month after the operation, by the end of the stage, pain during movement usually stops.
The last stage lasts about a year and depends on the characteristics of the skin regeneration of each woman. After a caesarean section, the scar changes its color to pink or pale pink, it becomes almost invisible (again, it all depends on the individual). The healing of the seam occurs due to the active production of collagen.

Women who, for health reasons, cannot give birth on their own, are prescribed a caesarean section. This is a difficult test for the expectant mother, because after it she not only recovers from anesthesia, but also monitors the condition of the stitches. The fact is that due to the complications associated with them, serious diseases can occur. One thing is clear - regular care is needed for the seams: we'll talk about this.

What is a caesarean section, types of incisions

A cesarean section is an operation for artificial resolution, involving the extraction of the baby and placenta through an incision in the abdominal anterior wall and body of the uterus. A caesarean section is performed with a live fetus if the woman is unable to give birth on her own.

The operation is also performed to remove a dead or non-viable baby if necessary to save the life of the mother: this usually happens with heavy and acute bleeding. There are two types of cesarean section: planned and emergency.. A planned operation is called if the indications for its implementation are determined before the start of contractions. With a planned caesarean section, a horizontal incision is made (along the suprapubic fold). With it, the abdominal cavity remains intact. Subsequently, the scar from such an incision will become almost invisible. Usually, after a horizontal incision, the doctor applies a cosmetic suture. The operation is scheduled for the following indications:

placenta previa, which is located above the cervix and closes the baby's way to the exit;
a small pelvis of a woman in relation to the fetus, or a fetus that is too large;
mechanical obstacles (uterine fibroids and other neoplasms);
diseases of the expectant mother that prevent natural delivery, posing a threat to the health of the woman (history of retinal detachment, diseases of the kidneys and cardiovascular system, etc.);
a scar on the uterus, left over from a previous birth;
complications of pregnancy that pose a threat to a woman's life (for example, severe preeclampsia);
multiple pregnancy;
breech presentation or transverse position of the fetus;
genital herpes at the end of bearing a baby: due to passage through the birth canal, the child can also become infected.

The horizontal caesarean suture is cosmetic, and sometimes staples are used to apply it.

An emergency caesarean section is performed with complications in natural childbirth that threaten the health of the mother and baby. Most often, during an emergency extraction of the fetus, doctors make a vertical incision (from the navel to the pubic zone, and the opening of the uterine wall occurs longitudinally). In another way, it is called corporal and involves the imposition of a nodal suture. Such a seam is rarely made and does not differ in beauty, as it is noticeable, and over time it becomes thicker and greatly increases in size. The reasons for the operation may be the following:

premature detachment of a healthy placenta, which can lead to a cessation of oxygen supply to the fetus and life-threatening bleeding;
slow labor activity or its complete cessation;
uterine rupture;
acute hypoxia (lack of oxygen in a child).

A vertical suture is rarely done, with an emergency caesarean section.

My grandmother had exactly a vertical seam: it is possible that earlier a vertical incision was made more often. Of course, my grandmother's caesarean section was planned, as she had severe diabetes. The appearance of the seam left much to be desired: it was about 8 cm wide. When I was little, every time I accidentally saw such a work of art, I involuntarily asked: “Grandma, does it hurt to give birth?”

How to process a seam after a caesarean section

In the maternity hospital, after the operation, nurses monitor the suture of the woman in labor. They treat it, change the bandage that keeps the scar from getting dirty and helps it heal. The doctor usually removes the suture on the fifth - eighth day after childbirth. In the first couple of days, set yourself up for the fact that the lower abdomen and the seam will hurt and cause discomfort, and this is quite normal. Regular emptying of the bowels and bladder will help to bounce back. However, this often does not happen due to the fact that the young mother does not feel the urge to urinate and defecate. A postpartum bandage will also help reduce pain, but you should use it only after the recommendation of a doctor. Usually these measures are enough, but sometimes the gynecologist still prescribes painkillers.

In the maternity hospital, nurses monitor the seam of a woman in labor after a cesarean section: they process it and regularly change the bandage

Before agreeing to painkiller injections and signing a consent to their use, you need to check with your doctor how safe such treatment will be while breastfeeding

The pain will pass after 3-4 days, and after a week the seam will heal. After discharge from the hospital, you need to take care of him yourself. The bandage and stitches will be removed at the maternity hospital, after which the wound will be examined: if there is a problem with its healing, then treat the scar especially carefully:

wash your hands with soap after every visit to the toilet: this will help prevent bacteria from getting into the seam;
do not carry heavy things (especially since the stroller usually has a shopping basket);
do not make sudden movements, do not strain the press;
While taking a shower, use intimate hygiene gel to cleanse the skin in the seam area, then wipe it dry with a disposable paper towel (bacteria accumulate in ordinary ones);
after a shower, disinfect the seam using salicylic acid, chlorhexidine, or a weak solution of potassium permanganate;
until the suture is completely healed, wear loose-fitting cotton underwear to avoid chafing the suture.

In the first days after a caesarean section, ask relatives for help in everyday affairs: it will be more convenient for relatives to take the child to the bath or buy the necessary products in the store

Treatment with Vishnevsky ointment

The good old Vishnevsky ointment continues to be used for inflammation of the seams. Moreover, its cost remains low - about 20–40 rubles per tube. The ointment is effective in the treatment of seams, it consists of natural ingredients: tar, castor oil and xeroform antiseptic, which makes it safe to use. Contraindication to use is only individual intolerance. The ointment is applied to the seam with a sterile bandage swab 2-3 times a day for a week.

Regarding the use of Vishnevsky's ointment, there are three opinions of doctors, among which there are positive and negative. Some say that the ointment irritates the nerve endings due to the limitation of heat transfer from the skin and the formation of a fatty film on its surface. As a result, a good blood flow is ensured and there is an increase in the onset of the inflammatory process. After this, the inflammation turns into abscesses, which quickly mature, open up and are freed from pus. But this is only one opinion of doctors - the other is based on the fact that as a result of the action of Vishnevsky's ointment, neoplasms that are life-threatening for women can appear on the skin. But this claim is disputed by scientists who have studied the drug. They say that all these statements are unfounded and are necessary in order for foreign, more expensive medicines to be in demand on the Russian market.

The use of chlorhexidine

Chlorhexidine is used as an antiseptic for treating stitches after a shower (as described above). Spray the incision with chlorhexidine or apply this drug to the incision with a sterile gauze pad. Chlorhexidine is not used for dermatitis and skin hypersensitivity. The price of the drug is inexpensive: it costs about 10 rubles.

Bepanthen for seams

Bepanthen is a safe drug, it is available in the form of a cream. A contraindication to its use may be individual intolerance to the components. However, as practice shows, no such cases have been identified, and the cream can even be used to care for an infant. Of course, its price can “bite” (400–800 rubles per pack), but a tube of the drug is enough for long-term use. Apply the cream to the surface of the scar with sterile bandage swabs: later, ordinary cotton swabs can be used to care for the seam.

Zelenka as a means for processing seams

Zelenka is a well-known antiseptic that has been used since Soviet times. It is also used to treat the seam after a cesarean section: when you apply chlorhexidine to it, generously grease the edges of the seam with greenery using a cotton swab. Do this procedure every day and be sure: the brilliant green will not let a single pathogenic bacterium through its “protection”. In a pharmacy, this drug can be bought at a price of 40 to 140 rubles. However, people with individual intolerance to its components will have to refuse the use of brilliant green.

Photo gallery: medicines for the treatment of sutures after caesarean section

Vishnevsky's ointment is applied to the suture after caesarean section with a sterile bandage swab Chlorhexidine is used as an antiseptic for suture treatment Bebanten is a safe drug, it is available in the form of a cream
The edges of the seam are smeared with green paint: a cotton swab is used for this

I myself did not have a chance to experience all the “charms” of a caesarean section, and my sister was more “lucky” in this regard. She had a horizontal scar that healed quickly with short-term use of chlorhexidine and brilliant green. Now, almost 9 years after giving birth, my sister's seam is almost invisible: to see it, you need to look closely.

Suture healing time after caesarean section

The duration of the healing of the suture after a cesarean section is influenced by the characteristics of the woman's body, and not only by the professionalism of doctors. The scar is completely formed in 8-12 months. After about a month, the seam is completely tightened and stops bothering. In the absence of complications, the woman forgets about him. To smooth the seam faster, additional methods are used:

restorative creams;
laser resurfacing (carried out after the seam is completely tightened);
mikradermabrasion (exposure to the seam with aluminum particles).

When stitches are removed

The time for removing the sutures depends on the type of incision: the cosmetic suture is applied with self-absorbable threads that do not need to be removed. These threads will disappear on their own 70-80 days after the caesarean section. The interrupted suture in a vertical (corporal) incision is removed 7–10 days after delivery. Many women worry about the pain of removing stitches. In fact, it only takes a few minutes and causes more discomfort than pain.

The cosmetic suture is applied with self-absorbable threads that do not need to be removed.

My friend gave birth to her son by caesarean section: she had her stitches removed on the 10th day after the caesarean section. She said that some girls got rid of the suture already on the seventh day after the operation.

How long does pain and discomfort last after a caesarean section?

Prepare for the fact that in the first two weeks after the operation, the suture and lower abdomen will hurt - this is considered the norm. In some cases, the pain may drag on for a longer period, or be completely unbearable: consult a doctor and he will help solve the problem. Warming up is usually prescribed, and for severe pain, the doctor recommends injections. But before you sign a consent to use painkillers, make sure they are safe for breastfeeding. Usually, after giving birth by caesarean section, doctors use non-narcotic analgesics, which are not absorbed into the bloodstream and do not enter breast milk. Oddly enough, frequent, unsharp movements will help to cope with pain.

When the weather changes and the season changes, the seams can make themselves felt for a long time. You should prepare for this in advance and keep a package of no-shpa in the first-aid kit. If the seams began to itch, then this is a good sign, but you still should not scratch them strongly: it is better to endure this time, because soon the seams will heal and you will forget about the itching.

When the weather changes and the season changes, the seams can make themselves felt for a long time

According to my friend, she did not experience pain and other discomfort in the seam area when the weather changed. Her seam began to itch on the fifth day, not much, which lasted for two days.

Possible Complications

The duration of the healing of the suture directly depends on the occurrence of complications in this process, which are early and late. Early complications occur even before the removal of the suture material: usually it is a hematoma or bleeding. A week after childbirth, a divergence of the seam, suppuration may occur. Late complications include ligature fistulas. The reason for their occurrence is the reaction of the body, rejecting the suture material. This complication can be recognized by the following signs:

swelling in the suture area;
redness;
pain;
the appearance of a neoplasm, which soon breaks through and oozes pus from it.

When a ligature fistula appears, you need to consult a doctor who will remove the problematic thread and tell you how to smear the damaged area.

When a ligature fistula appears, you need to consult a doctor who will remove the problematic thread and tell you how to smear the damaged area

Seam bleeding

This complication occurs due to divergence or inflammation of the suture. It is accompanied by high fever, purulent discharge, severe pain in the suture area. The doctor will establish a more accurate diagnosis: a visit to him does not need to be postponed.

Persistent pain in the area of stitches

Sometimes pain in the suture area after cesarean section is associated with the following complications:

Inflammation of the uterine cavity involving internal sutures (endometritis). This complication is accompanied not only by pain in the suture area, but also by a pulling painful sensation in the lower abdomen, discharge with an unpleasant odor, and an increase in body temperature. Endometritis is a serious complication that requires anti-inflammatory and antibacterial treatment. If timely action is not taken, the problem can lead to the removal of the uterus or death.
The formation of adhesions. In this case, the doctor prescribes symptomatic therapy, since adhesions usually do not resolve. Sometimes, after several years after a caesarean section, laparoscopic operations are performed to dissect adhesions.
Involvement of nerve endings in the suture itself. Such pain is not eliminated in any way: the doctor simply prescribes painkillers.
Endometriosis, which appears due to the collection of endometrial cells in the area of the external suture during a caesarean section. In this case, the woman experiences pulling pain during menstruation. This complication cannot be eliminated: the doctor simply prescribes painkillers, sometimes hormonal drugs.

Feeling of heaviness in the perineum

If in the first 3-5 days after the cesarean section there is a feeling of heaviness in the perineum, then it is possible that a hematoma has formed here due to the accumulation of blood. Usually, a woman learns about such a complication even in the maternity hospital and can quickly notify the medical staff about her feelings. The method for treating a hematoma is selected depending on its size:

a small hematoma is eliminated by applying cold to the perineum, the introduction of hemostatic drugs, a state of rest;
a small but growing hematoma is opened to detect a bleeding vessel, which is ligated, sutured and drainage is left:
the festering hematoma is opened, the wound is washed with an antiseptic, antibacterial drugs are injected.

Painful swelling of wounds

This issue may occur for the following reasons:

inflammation associated with improper postoperative treatment;
tissue infection (hardening, complication with burning and itching) during surgery or during treatment;
the use of low-quality material (expired threads): the problem requires additional surgical intervention;
postoperative hematoma resolves after a few days;
reaction of the body: rejection of medical materials (eliminated by the selection of other materials or the appointment of a means to stop the activity of the body system).

Suppuration

If a cloudy white-yellow liquid is released from the wound, then the suture has suppurated. This complication often occurs with artificial delivery. Usually, with suppuration, a woman has other symptoms of a complication:

chills;
heat;
pain on movement;
general loss of strength.

In this case, you need to urgently consult a doctor who will disinfect the wound and prescribe the appropriate treatment.

Suppuration is accompanied by other symptoms: fever, chills, pain during movement

Seam granulation

This complication looks like swelling at the site of the suture. Connective tissue develops at the seams, forming elements that look like grains. Usually, doctors recommend truncation of the formation if it causes discomfort. During granulation, the seam does not hurt, does not itch, does not cause other unpleasant sensations.

When granulated, the seam does not itch, does not hurt, does not cause other unpleasant sensations

Failure of the scar on the uterus

This complication is considered a frequent and complex pathology, which requires surgical intervention. An incompetent scar is an abnormally formed scar tissue at the site of the uterine incision. In pathology, non-united areas and cavities can be detected. At the same time, there is more connective tissue, which will prevent the uterus from stretching during the next pregnancy. Common causes of this pathology are:

the appearance of postoperative endometritis;
performing an emergency caesarean section;
re-pregnancy that occurred almost immediately after surgery;
termination of pregnancy by curettage after caesarean section;
inflammation or infection of the suture.

With the insolvency of the scar in the process of carrying the next fetus, the wall of the uterus may not withstand and burst. This often causes severe bleeding and death of the mother and baby. If this pathology was detected on an ultrasound, then you should definitely consult a doctor: he will tell you what to do. Usually there are only two ways out - open (laparotomic) surgery or laparoscopic correction of a pathologically altered scar. Doctors recommend choosing the first option, since you can get out of such an operation with less blood loss.

If threads come out after a caesarean section

Sometimes it happens that self-absorbable threads can come out of the suture. This is considered the norm if the seam heals well, does not turn red, does not fester. No bubbles with purulent or liquid contents should appear on it. If you just noticed the threads, then do not worry: they will soon resolve or come out on their own.

If the suture after caesarean section heals well, then you should not worry about the fact that self-absorbable threads began to stick out on it: soon they will come out on their own

The seam itches: a complication or a pattern

A week after the caesarean section, the seam begins to itch, sometimes very strongly. This usually indicates that the suture is healing. You need to sound the alarm in case of suppuration, redness at the site of itching, as well as fever. Itching should not be accompanied by bleeding from the suture area.

According to my friends and girlfriends who gave birth by caesarean section, most often the seam heals without complications. Therefore, if such an operation awaits you, then do not be afraid of anything and feel free to go for the baby.

The seam broke after a cesarean section: symptoms and actions

The first and main symptom of seam divergence is bleeding, wetting of the bandage. In these cases, you need to treat the bandage or suture with dimexide and immediately consult a doctor. Often the seam diverges 1-2 days after the removal of ligatures (medical threads). During this period, a woman should reduce physical activity. Usually the suture is not re-sutured, but a local treatment is prescribed, which contributes to the rapid healing of the wound. In another way, this process is called "secondary tension". If the inner seam has opened and the wound has not yet healed, the doctor will apply it again. The doctor usually does not sew up a half-opened seam.

With the divergence of the seam, suppuration of the wound may occur. In this case, the doctor will install a drain that allows you to quickly clean the wound. This must be done, as inflamed tissues cannot grow together. Sometimes, due to suppuration of the wound, the doctor removes the surgical threads prematurely.

Re-pregnancy after caesarean section: when to plan

2–3 years after cesarean section, muscle tissue is restored on the uterine scar. With the onset of pregnancy at an earlier date, the scar is still weak and the likelihood of its divergence and tearing of the cervix increases. Abortion during this period is also prohibited, since exposure to the uterine wall or its mechanical stretching can lead to weakening, rupture or inflammation of this organ. At this time, doctors recommend taking the issue of contraception seriously.

If you choose a method of delivery after a caesarean section, then, according to scientists, natural childbirth has a more beneficial effect on the body than a second operation.
A month after cesarean section, the suture is well scarred Completely the suture is scarred 2–3 months after cesarean section
In the process of caring for a baby, a woman forgets about her health, so complications occur after a cesarean section. Proper care of the seam, which includes hygiene procedures and disinfection, will help to do without them. The seam heals and hurts differently for everyone, but in the end everything passes, and only the time of happy motherhood remains.

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Types of surgical sutures

Depending on what reasons predetermined the decision of the surgeon to conduct abdominal delivery, the types of sutures after cesarean section also differ. Most often used:

horizontal. It is mainly used for planned operations. It is performed horizontally in the suprapubic region using a self-absorbable suture material. After a transverse caesarean section, the scar becomes almost invisible over time;
vertical. A vertical incision allows you to get full access to the internal organs in case of complications in the birth process. The scar after such obstetrics remains longer and rougher, heals longer. When performing such an operation, the use of absorbable catgut is impossible - the seam may disperse;

In addition, an internal suture is applied to the uterus after a caesarean section. If the woman's recovery process goes without complications, it resolves after about 6-8 weeks. Uterine contraction promotes faster healing of internal sutures. For the first week, the external seams will require careful care.

Suture care in the maternity hospital

All care for the woman while she is in the maternity hospital lies on the shoulders of the medical staff. In the first days after the operation, the woman does not have to carry out any manipulations to care for the scar on her own. After delivery, the caesarean scar is covered with a sterile dressing to prevent infection and mechanical damage. The bandage is changed by a nurse in the manipulation room. If everything goes without complications, it takes about 6-7 days to process the suture after a caesarean section. The most commonly used antiseptics are:

brilliant green solution;
chlorhexidine;
hydrogen peroxide;
fucorcin;
iodicerin.

The task of the woman in labor is the unconditional observance of the regimen and recommendations of the doctor. An unhealed scar is "afraid" of water. It is strictly forbidden to wet it in the first days - it can become inflamed. Wearing a special bandage allows you to reduce the load on the muscle tissue of the abdomen, which contributes to the speedy healing of the wound. It will also depend on how long the suture heals after a cesarean. As a rule, sutures, if non-absorbable suture material was used, are removed already 5-7 days after the operation. The question of whether it hurts to remove stitches after a caesarean very often worries women in labor. There is no cause for concern - in the vast majority of cases today, sutures are applied using absorbable threads that do not require subsequent removal. If, nevertheless, the stitches need to be removed, then the woman may feel slight discomfort when removing the stitches and subsequent spot treatment of the wounds left from the threads. In these places, a slight seal on the seam may be observed for some time. Now the woman is ready to be discharged from the maternity hospital.

Seam care at home

Before discharge from the maternity hospital, the patronage nurse will definitely instruct and explain how to care for the suture after cesarean, what medications will be required for this, but most often the treatment of the suture after cesarean section is no longer required from the moment of discharge from the hospital, the woman in labor simply needs to carry out general hygiene measures.

In addition to the antiseptic, which has already been used in the hospital, you can use special gels and ointments that contribute to the rapid healing of the scar. But this can only be done if the wound surface is dry and the seam does not bleed. Before using such drugs, you should always consult with your doctor - only he makes a decision on how to process the seam so that there are no complications. If required, a woman in labor can independently apply a sterile dressing; with the current variety of dressing materials, this will not be difficult and will not require special skills. The most important rule is meticulous hygiene. Before processing the seam, you must thoroughly wash your hands and treat them with disinfectants. After the seam stops getting wet, the need for dressing will disappear.

Pain complaints

Pain is the most common cause of women's complaints, especially in the early days. Moderate pain after a caesarean section should not cause alarm, because they have a completely understandable physiological cause and are a natural reaction of the body to the dissection of not only the skin, but also soft tissues. In a medical institution, pain is relieved with the help of narcotic analgesics and painkillers. The appointment of such drugs is the prerogative of the doctor. In response to the question of how long the seam hurts after a cesarean section is normal, doctors give only an approximate answer: from two to six weeks in the absence of complications.

The stomach will hurt in the first weeks or even months, and in the very first days any movement, deep breathing, coughing can cause pain. Despite this, doctors do not recommend "stale" in bed. After six hours, the woman in labor can already rise, and on the second day she can start walking. This should be done slowly and without choppy movements - there is a high probability of dizziness. It is better if at this time a hospital employee or one of the relatives will be next to the woman. Wearing a bandage reduces pain by reducing the load on the abdominal muscles.

Not always pain in the suture area can be correctly interpreted by a woman. Pain can cause:

accumulation of gases in the intestine, the peristalsis of which is disturbed during the surgical intervention;
contraction of the uterus. With the onset of lactation, a woman's body produces oxytocin. This hormone contributes not only to the production of breast milk, but also has an active stimulating contraction of the smooth muscles of the uterus, which can temporarily cause pain in the lower abdomen.

A woman in the postoperative period should still be attentive to the nature of pain and their localization. Severe, sharp pains, fever may indicate inflammation of the uterine cavity or that there has been a divergence of the stitches after a cesarean section.

Often women complain that, despite the quality care of the suture after cesarean section, it itches. In no case should this be a cause for concern - after the operation, a natural healing process takes place, tissues are regenerated. Already after a certain amount of time, after the sutures are removed, or as the catgut is resorbed, if it is a cosmetic suture after a cesarean section, the itching will weaken, and then completely disappear. For someone it happens slowly, for someone faster: a lot depends on the type of suture and the individual characteristics of the skin.

What to do if the seam oozes after cesarean

The isolation of a transparent ichor on a scar after a cesarean in the first days should not disturb the woman in labor: very often this is how healing takes place. The situation is quite different if the discharge has become purulent, the discharge is bloody in nature, and there is a sharp and unpleasant odor. Along with this, an increase in local or general body temperature may occur. This indicates that the seam has become inflamed. Inflammation can be caused by infection, but sometimes rejection of the suture material occurs due to the individual characteristics of the woman's body. In a mandatory manner, you need to consult a doctor if the discharge continues for a long time, and, as a result, the suture does not heal after a cesarean. Treatment consists in creating an outflow of purulent contents and antibiotic therapy.

Possible complications in the healing process

Advances in anesthesiology and surgery, the use of modern antibiotic therapy have made cesarean section relatively safe for women's health.

But still, in the process of healing the postoperative suture, various complications can occur. These problems should be solved exclusively by the attending physician. Self-medication can cause significant damage to a woman's health. You should consult a doctor if:

bleeding has opened from the seam;
there was a seal over the seam after cesarean;
inflammation and suppuration occurred;
the seam came apart after caesarean.

In the event of the development of such negative consequences of the operation, the doctor will definitely prescribe treatment. Treatment with antibiotics and antibiotics will be required. Only a doctor can pick them up taking into account the lactation period in a woman.

Late complications of the recovery period include:

the occurrence of keloid scars. A caesarean section scar is not so much a medical as an aesthetic problem. Laser and plastic surgery today successfully fights keloid scars;
ligature fistula. The wound becomes inflamed and festering at the site of a non-absorbable surgical thread that was not removed in time. The seam connection may be broken. Treatment is carried out by removing the festering thread and applying topical antibacterial ointments.
Hernia. It occurs due to the large load on the scar with a vertical incision. Subject to surgical treatment only.

Features of the recovery period

In order for the recovery of the body of the woman in labor to take place in the shortest possible time, she will need to strictly follow many of the recommendations of doctors. Here are the main ones:

Strict observance of personal hygiene.
Strict adherence to the diet in the postoperative period.
Don't lie. The movement stimulates the contraction of the uterus, the recovery process of the body will be faster.
Give preference to underwear made of cotton jersey. Synthetic underwear, especially tight ones, can slow down the blood flow in the wound, which negatively affects its healing.
You can sit down no earlier than 2-4 days later.
Mandatory daily bowel movements.
Restriction in lifting weights.
Sports activities can be started no earlier than two months later.
It is necessary to take care of the abdominal muscles. Use squats instead of bends.
Sexual relations can be resumed no earlier than after 6-8 weeks.
Treat the scar only with antiseptics recommended by your doctor or nurse.
Any symptoms that bother a young mother should be reported to the doctor. It is better to get advice and resolve the problem than to smear the seam after cesarean with ineffective ointments or be treated with traditional medicine.

The recovery period is a long process and must be treated with all responsibility. A woman should be patient, because her uterus will shrink much longer than the uterus of a woman who gave birth naturally - the integrity of the tissues from the caesarean section is broken, and the scar on it will finally heal only by the end of the first year. The healing time for external scars is very individual. The same applies to their appearance. If the aesthetic side of the issue is of great concern to a woman, modern methods will come to her aid - laser correction and cosmetic plastic surgery.

Caesarean section is a common obstetric operation. A woman who has given birth to a child by caesarean section should receive the necessary stock of knowledge on how to return to active life as soon as possible and without any complications, to recover after surgery. Women who have had a caesarean section are concerned about whether the operation can affect the ability to take care of the newborn, how long the suture heals after cesarean section, what to do with possible complications, how aesthetically will the scar after cesarean section look when the sutures are removed after cesarean? All this depends not only on the skill of the surgeon, but also on how the woman in labor will follow the recommendations of the doctor after discharge from the maternity hospital. Violations of the regimen, rules of hygiene and sanitation, neglect of the rules for caring for the postoperative area can cause stitches after a cesarean section to cause a deterioration in the general well-being of a woman.

- a type of surgical intervention that is quite common today, during which, as after any operation, a small seam remains on the body. And despite the fact that a pregnant woman knows in advance about the upcoming operation (at about 20-22 weeks, when all the tests were taken and the first ultrasound was done) and she, so to speak, has time to prepare (mostly mentally), there are a number of questions that continue to bother her

For example, how long does a cesarean section stitch heal, will it be noticeable, how to care for it, and what to do if the incision becomes inflamed or parted. An experienced doctor (obstetrician-gynecologist) should answer all these questions to the woman in labor immediately before (for better digestibility) and, of course, after the operation. In addition, do not be shy and contact the doctor at the site (the therapist or gynecologist) with questions of interest and problems that arise regarding the state of the suture after surgery, after returning home.

Types of seams

The condition of the suture after the operation depends, first of all, on how the caesarean section was performed: according to plan or urgently.

After all, if a woman knows in advance about the upcoming operation, she will be able to “tune in” to a quick recovery, because it’s not in vain that they say that thoughts are suggestible.

And it’s a completely different matter when a pregnant woman who went to a natural birth, for quite understandable reasons, mainly of a medical nature, decide to be caesarean - hence the fear and panic about the current situation.

After the operation, the suture remains on uterus (internal) and skin (external).

As for the direction - the incision can be made vertically- from the navel to the pubis (most often during emergency surgery, if bleeding begins or there is a threat to the life of the baby or mother) and horizontally- transverse seam (similar to an arc). It is located on the skin fold near the pubis (they also joke - like a “smiley face” on the stomach). And if in the first case the seam is far from being so beautiful even after a certain period of time has elapsed, then a horizontal incision (in medicine this operation is called Pfannenstiel laparotomy) is more aesthetic and over time (of course, subject to certain rules) it becomes almost invisible. In rare cases, a transverse suture is made, located 3 cm below the middle of the distance from the navel to the womb (laparotomy according to Joel-Cohen).

Care, peace and no burdens

So how does the healing process go?

In order for the condition of the woman after the operation, whether she or emergency, to stabilize, 5-7 days must pass (from the moment of the surgical intervention to discharge from the maternity hospital). During this time, the woman in labor will receive the necessary course of antibiotics and other medicines that help reduce pain, compatible with breastfeeding.

In the first 2-3 days, painkillers are required, then they can be given as desired, depending on how much pain is felt in the abdomen and uterus.

Gradually, addiction to this kind of pain occurs, and besides, you need to understand (and especially accept!) That when the mother and baby return home, most of the pills that can relieve pain are contraindicated for her. But do not be afraid - the pain will gradually go away, especially if you follow a number of rules prescribed by doctors.

The only thing that you really have to endure is the first discomfort after the operation. 10-11 hours after surgery, the woman in labor is asked to get up and, moreover, to begin to move actively. And this is very important, because the more you move, the faster the pain goes away and the seam heals. It is even allowed to sit, but just do not lie on your back all day.

Firstly, bedsores can form, secondly, the seam can fester, and thirdly, less movement means more pain.

If a woman is full, a postoperative bandage will help to cope with painful omissions.

Do not confuse it with postpartum, it is advisable to purchase a postoperative one, as it will help at least somehow immobilize the wound when moving. Feel free to ask a nurse or roommate to "pack" you into this wonderful corset, the main thing is that as a result you can walk and carry the baby in your arms.

While the woman is in the hospital, the nurses carefully look after her suture - they treat it with brilliant green, and in case of suppuration, they open it and clean it.

It happens that the seam begins to get wet - due to insufficient motor activity, lack of air access (especially if a pocket is formed from an overhanging abdomen), the temperature rises or other complications arise. All these inconveniences are completely eliminated, the main thing is to notify the doctor in time (if he himself does not notice the problem during the daily examination) about the discomfort.

After 7 days there is an extract. If the seam is cosmetic, the threads are not removed from it, only knots are removed along the edges, and over time, the remaining particles disappear on their own. If the seam is made vertically, the seams will be removed from it only after 7 days (in general, it takes about 14 days to heal). To do this, a woman should come to the emergency department of the maternity hospital in which she gave birth and see the doctor on duty.

After discharge, the suture must also be carefully looked after. In no case do not rub it with a washcloth when taking a shower, since it is not recommended to take a bath until complete recovery (and this is 2 months). It is advisable to simply lather your hand with household (it dries better) or baby (ph-neutral) soap, but flavored cosmetics should be avoided, as they can cause an allergic reaction, rinse the seam and rinse with water. Then dry thoroughly with a towel.

By the way, the occurrence of allergies at the site of the seam is not such a rare occurrence. This can happen for any reason - an overabundance of antibiotics in the blood, an "inappropriate" remedy for healing, and, finally, just a reaction to brilliant green.

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What to do if the seam after cesarean is inflamed

If the seam after a caesarean section is inflamed, reddened, or even partially dispersed (as if the skin was neatly divided into two parts), you can try to treat yourself or consult a doctor. Of course, the second option is preferable, but, having assessed the situation, it is possible to cope on our own. And then again brilliant green will come to the rescue - it will dry, hydrogen peroxide - “kills” the infection (until the place of the seam stops hissing) and healing ointments and powders.

Medicines are very good in such cases - Baneocin powder and Levomekol ointment, but both have side effects, so read the instructions carefully and pay attention to the condition of the seam and abdomen after their use. If it suddenly happens that the seam has opened after a cesarean, contact your doctor as soon as possible, as there is a risk of infection, and in rare cases, the inner seam may also open, and this is a repeated hospitalization and a possible mini-operation.

It happens that the seam after a caesarean section becomes hard– keloid, red in color and quite thick. This kind of scars occur only with a longitudinal incision. They can be smeared with ointments to reduce the effect, or you can seek help from plastic surgery professionals.

Little tricks for a quick recovery

To avoid discrepancy and contribute to the rapid healing of the suture after a cesarean section, following several rules will help:

Do not lift weights - it is allowed to pick up only your baby;

Feeding - only in the supine position, at least in the first months;

Wearing a bandage - it does not allow the internal organs to move strongly, causing pain;

Compliance with the rules of hygiene and diet so that the intestines and stomach return to normal faster;

Carrying out daily therapeutic exercises.

And one more little trick - every time you have to get out of bed, use one hand as a kind of weighting device, for example, if you are trying to get up through your right side - put your right hand on your stomach and lightly press it in the navel area, as if holding on one place, and with your left (over your right hand) grab the side of the bed or something else and pull yourself up. And vice versa - right to left, if through the left side. At first, this will help you quickly cope with the difficulties that arise when getting out of bed.

Doctors also advise getting up on tiptoe after surgery and walking around for a few minutes a day. As for the exercises, their action is aimed at relieving pain in the spine (especially the calf), legs and abdomen.

It is very important to lie on your stomach as often as possible. In this position, the healing process is accelerated, the uterus begins to contract more often, which leads to an improvement in the general well-being of the woman.

Very efficient heating

It can also be like warming up. For example, in some maternity hospitals today there are magnetic devices, the action of which is aimed at the rapid healing of wounds received during the operation.

Sometimes it happens that there are painful and pulling sensations along the edges of the seam - you should not be scared, unless of course there are a number of other conditions. Perhaps, during the operation, they took a little extra skin - everything goes away with time. The same applies to slight twitches, as if the nerve in the tooth is pulling. If you move a lot, all pain will disappear. And of course - breastfeeding, it best helps to cope with any manifestations of pain.

How to remove a stitch after a caesarean section

Many women are also interested in the question: how to remove the seam after a cesarean section. The solution to the problem is possible, but only after complete healing and ultrasound. By the way, after a cesarean, the diagnosis of the state of the seam is done 2 months after the operation, then every six months. According to the data obtained during the study, it will be possible to see what condition the internal suture is in, whether there are adhesions or fistulas, how the external suture has healed.

The best option for seam correction is laser resurfacing, which removes damaged tissue from the incision. However, this process is very painful and requires a course of medications that exclude the occurrence of any kind of infection at the site of the scar.

The most expensive procedure is suture excision, when coarse collagen particles and vessels that have grown at the incision site are removed under local anesthesia along with excess skin and a new abdominal contour is formed.

It is also possible to carry out a chemical peel, grinding the seam with aluminum oxide (microdermabrasion), get a tattoo or simply apply a special tool that helps to make the postoperative seam invisible. The components that make up this kind of ointment help prevent the appearance of scar tissue, as well as increase collagen production and help reduce the size of the scar.

A scar from a caesarean section will not please any woman, and yet, if the operation cannot be avoided, then you will have to put up with the presence of a scar on your body. In the future, it is quite problematic to withdraw it due to the specifics of the operation itself. However, there is a positive side, when you will have a second birth, you will not get another scar, the incision will pass strictly along the first scar.

What are the seams?

During a caesarean section, absolutely all tissues of the abdominal cavity are incised, starting from the surface of the skin of the abdomen, then fat cells and muscle tissue, and the walls of the uterus are directly incised. The incision should not be small so as not to cause damage to the baby during its extraction from the uterus.

There are several options for this operation. They differ from each other in the technique of the cut. If force majeure occurs during labor, for example: fetal hypoxia or severe bleeding in the expectant mother, that is, everything that entails a rapid birth, then doctors choose a corporal cesarean section. In this case, the incision runs vertically from the navel to the pubis and a longitudinal incision is made in the uterus. This is called a lower midline laparotomy.

Vertical seam after cesarean (photo)

The seam from such a cut is very difficult to hide, the fact that in the future it loses its shape and becomes wider is still a little pleasant.

Pfannenstiel laparotomy

This is a transverse incision that takes place in the lower abdomen, above the pubis. It differs from a corporal caesarean section in that in this case there is no penetration into the woman's abdominal cavity. The walls of the uterus are also cut across in its lower part.

After laparotomy according to Pfannenstiel, a cosmetic suture is applied, due to its location on the fold of the abdomen above the pubis, such a scar does not experience tension and this makes it possible to heal as soon as possible, later it can become almost invisible. After a vertical incision, stronger interrupted sutures are always applied, since this suture holds all the tissues of the abdominal cavity together.

Horizontal cosmetic suture after cesarean (photo)

The same incision that is made on the walls of the uterus has many variations of sutures applied to it later. There are methods of hardware overlaying of ligatures. All these methods and innovations are used for better and faster healing of the walls of the uterus and prevention of blood loss.

So after the "royal incision" a second pregnancy must be planned. The seam heals and becomes as strong as possible in the second year after the operation, it is best to take this particular period of time for re-conception. The state of your seam is best determined by ultrasound - ultrasound.

How long does the seam heal after cesarean

Finally, the operation is over and you will soon meet your long-awaited baby.

The question arises: when will the seam heal?

Painful sensations will come to you immediately after the operation and will definitely stay with you for the next two days, of course, you will knock them down with painkillers. Women in the body are recommended to wear a bandage, it will at least slightly immobilize the incision site. Be that as it may, on the second day, the doctors insist that you begin to move slowly. Movement will help your intestines work, constipation occurs after childbirth. In general, any manifestation of activity contributes to a speedy recovery, and this is so necessary for you and your baby, because both of you have been waiting for this meeting for so long.

Why does the seam hurt after a cesarean section?

The most unpleasant consequences of a caesarean section is a very strong pain syndrome. Pain can last for quite a long period, medical intervention can not always completely get rid of them. But as a rule, on the 14th day you will feel some relief. However, the sensitivity of the scar zone will be lost, numbness and itching are possible, for a long period after the operation.

When are stitches removed after caesarean?

As described earlier, interrupted sutures are applied to the vertical incision, and cosmetic sutures are applied to the transverse ones. Naturally, the sutures on vertical wounds take longer to heal, they are removed for about 10 days. With cosmetic ligatures, it is a little easier, since they are considered to be almost subcutaneous, and they heal more painlessly and faster. Cosmetic sutures are always removed on the 7th day. Remember that getting rid of the stitches does not mean a complete recovery, even after you are discharged the wound will be covered with a non-healed crust, this place will need to be treated with special means, do not disturb or strain.

Getting back in shape after a caesarean

You can partially take a shower (not entirely) after 2 days, however, before discharge from the hospital, it is not recommended to fully stand under the shower. In order not to damage the crust on the postoperative suture, it is better to use a special fragrance-free soap when washing. It is allowed to take a bath not earlier than after 6-8 weeks, when the healing and restoration of tissues and the condition of the inner surface of the uterus is over. As for the bath, you can visit it only after consulting a doctor no earlier than 2 months after the operation. To accelerate the recovery processes and resorption of the scar, it is proposed to use prednisolone ointment or contractubex gel. Also around the scar itself, the crossed nerve fibers will grow together within 3 months, so some numbness in this area is possible.

Physical fitness should also be restored very gradually, although this is undoubtedly important and necessary. A special postpartum bandage is recommended to be worn to relieve pain, unload the spine in the lumbar region, strengthen muscles, restore them and maintain correct posture. In addition, it promotes wound healing by reducing the risk of sutures coming apart. However, it is necessary to load the muscles so that they recover properly, so you should not wear a bandage for a very long time either. After a few weeks, based on the state of health, the condition of the abdominal muscles, it can be removed.

You also need to do simple therapeutic exercises, which are allowed to start already 6 hours after the operation, while the load should increase gradually. When the stitches are removed, you can consult a doctor and start exercises for the muscles of the pelvis and the anterior abdominal wall: pull in the stomach, raise the pelvis, perform the Kegel exercise with gradual relaxation and compression of the pelvic floor for 20 seconds. All this speeds up the recovery process, as it creates an additional blood flow to damaged organs. In addition, such gymnastics not only restores physical fitness, but also contributes to the release of endorphins - hormones that improve the psychological state, relieve tension, depression, and low self-esteem.

In the first 1.5-2 months, it is better not to lift more than 3-4 kg. After 6 weeks, it is allowed to increase activity, focusing on the physical form that was before pregnancy. Again, the exercises should be added gradually, avoiding the power load on the upper body, because the milk may disappear. Active running and aerobics are also not recommended, although in the future, after discussion with the trainer, they can be included in the program. It should be borne in mind that after intense training, the concentration of lactic acid increases, so the taste of milk worsens, which may not please the baby. So serious sports activities are recommended to be postponed until the end of breastfeeding or until the restoration of the menstrual cycle. As for sexual activity, it can be resumed after 6-8 weeks, after visiting a gynecologist and determining the correct method of contraception.