Cosmetic seam after caesarean section how to remove. Suture after caesarean section - photos and reviews of women

Cesarean section - delivery surgery, during which the child is removed through an incision in the uterus. Despite all its advantages and sufficient popularity today, young mothers are worried about how after a while the seam after caesarean section how much it will be noticeable and how long the healing process takes. It depends on what kind of incision was made by the surgeon, whether there will be complications in the postpartum period, and how competently the woman takes care of the operated area of ​​her body. The more knowledgeable a woman is, the more less problems she will have in the future.

The reasons why a doctor decides to do a caesarean section can be very different. Depending on the delivery process and the complications that have arisen in its course, incisions can be made in different ways, and as a result, different types of sutures are obtained that require special care.

vertical seam

through the pages of history. The name of the caesarean section comes from Latin and literally translates as "royal cut" (caesarea sectio).

In the hospital

The first suture treatment after a caesarean section is done in the hospital.

1. After the examination, the doctor decides how to treat the seam: in order to avoid infection, antiseptic solutions are prescribed (the same green stuff belongs to them).
2. All procedures are performed by a nurse.
3. The dressing is changed daily after the caesarean.
4. All of this takes place over the course of about a week.
5. After a week (approximately) the sutures are removed, unless, of course, they are absorbable. First, the knot that holds them is plucked from the edge with a special tool, and then the thread is pulled out. As for the question of whether it hurts to remove stitches after a caesarean section, the answer is unlikely to be unambiguous. It depends on different levels pain threshold. But in most cases, the procedure is comparable to plucking the eyebrows: at least the sensations are very similar.
6. In some cases, an ultrasound scan of the suture is prescribed after the operation in order to understand how the healing is going, whether there are any deviations.

But even in the hospital, before discharge, no one can tell you exactly how long the suture heals after a cesarean section: the process is definitely individual for everyone and can follow its own, separate trajectory. Much will also depend on how high-quality and competent the home care for the operated area will be.

home care

Before being discharged home, a young mother needs to learn from a doctor how to care for a suture after a cesarean section without medical assistance, at home, where there will be no qualified medical personnel and professional aids.

1. Do not lift heavy things (anything that exceeds the weight of the newborn).
2. Avoid strenuous exercise.
3. Do not lie down after a cesarean all the time, walk as much and as often as possible.
4. If there are any complications, it will be necessary to treat the seam at home with brilliant green, iodine, but this can only be done with the permission of the doctor if the scar gets wet and oozes even after discharge from the hospital.
5. If necessary, watch a special video or ask your doctor to tell you in detail how to process a stitch at home. At first, it is not the scar itself that is wetted, but only the area of ​​​​the skin around it, so as not to burn a fresh wound.
6. As for the timing, how much the suture needs to be processed after a cesarean section, this is determined by the nature of the discharge and other features of the healing of the scar. If everything is in order, a week after discharge will be enough. In other cases, the time is determined by the doctor.
7. To prevent the divergence of the seam, wear a fixing belly.
8. Avoid mechanical damage after cesarean: so that the scar is not subjected to pressure and rubbing.
9. Many doubt whether it is possible to wet the seam: after discharge from the hospital, you can take a shower at home without a doubt. However, you do not need to rub it with a washcloth.
10. Eat right for faster tissue repair and faster healing of scars.
11. By the end of the 1st month, when the wound heals and the scar forms, you can ask the doctor how to smear the seam after a cesarean section so that it is not so noticeable. Pharmacies now sell all kinds of creams, ointments, patches and films that improve skin recovery. Ampoule vitamin E can be safely applied directly to the scar: it will speed up healing. A good suture ointment that is often recommended for use after a caesarean is Contratubex.
12. Several times a day (2-3) for at least half an hour, expose the stomach: air baths are very useful.
13. Constantly see a doctor. It is he who will tell you how to avoid complications, what can and cannot be done, when to do an ultrasound of the seam and whether there is a need for this.

So caring for a suture after a cesarean section at home does not require any special efforts and supernatural procedures. If there are no problems, you just need to follow these simple rules and pay attention to any, even minor deviations from the norm. They should be reported to the doctor immediately: only he can prevent complications.

It is interesting! Not so long ago, scientists concluded that if the peritoneum is not sutured during cesarean delivery, then the risk of speck formation is reduced to almost zero.

Complications

Complications, serious problems with a suture after a cesarean section in a woman can occur at any time: both during the recovery period and several years later.

Early Complications

If a hematoma has formed on the suture or it bleeds, most likely, medical errors were made during its application, in particular, the blood vessels were poorly sutured. Although often such a complication occurs with improper processing or inaccurate dressing change, when a fresh scar was roughly disturbed. Sometimes this phenomenon is observed due to the fact that the removal of the sutures was performed either too early or not very carefully.

A fairly rare complication is the divergence of the seam, when the incision begins to creep in different directions. This can happen after a cesarean on days 6-11, since the threads are removed within this period. The reasons for the seam to open may be an infection that prevents the full fusion of tissues, or the weight of over 4 kg that the woman lifted during this period.

Inflammation of the suture after caesarean section is often diagnosed due to insufficient care or infection. Alarming symptoms in this case are:

• fever;
• if the seam is festering or bleeding;
• his swelling;
• redness.

So what to do if the seam after a cesarean section is inflamed and festering? Self-medication is not only useless, but also dangerous. In this case, it is necessary to consult a doctor in a timely manner. In this case, antibiotic therapy (ointments and tablets) is prescribed. Advanced forms of the disease are eliminated only with the help of surgical intervention.

Late Complications

Ligature fistulas are diagnosed when inflammation begins around the thread, which is used to sew blood vessels during cesarean section. They form if the body rejects the suture material or the ligature is infected. Such inflammation appears months later as a hot, reddened, painful lump, from a small hole in which pus may flow. Local processing in this case will be ineffective. The ligature can only be removed by a doctor.

Hernia is a rare complication after cesarean. Occurs with a longitudinal incision, 2 operations in a row, several pregnancies.

A keloid scar is a cosmetic defect, does not pose a threat to health, and does not cause discomfort. The reason is the uneven growth of tissue due to individual features skin. It looks very unaesthetic, like an uneven, wide, rough scar. Modern cosmetology offers women several ways to make it less noticeable:

• conservative methods: laser, cryo-impact (liquid nitrogen), hormones, ointments, creams, ultrasound, microdermabrasion, chemical peeling;
• surgical: excision of the scar.

Cosmetic suture plastic surgery is selected by the doctor in accordance with the type of incision and individual characteristics. In most cases, everything goes fine, so that no external consequences of a caesarean become practically visible. Any, even the most serious complications, can be prevented, treated and corrected in time. And you need to be especially careful for those women who will give birth after the COP.

Blimey! If a woman no longer plans to have children, the scar after a planned cesarean can be hidden under ... the most ordinary, but very elegant and beautiful tattoo.

Subsequent pregnancies

Modern medicine does not prohibit women. However, there are certain nuances regarding the seam that you will have to face when carrying subsequent children.

The most common problem - the seam after a cesarean section hurts during the second pregnancy, especially in its corners in the third trimester. Moreover, the sensations can be so strong, as if it is about to disperse. For many young mothers, this causes panic. If you know what this pain syndrome is dictated by, fears will go away. If a period of 2 years was maintained between caesarean and subsequent conception, the discrepancy is excluded. It's all about the adhesions that form during the restoration of wounded tissues. They are stretched by an enlarged belly - hence the unpleasant, pulling pain. You will need to inform your gynecologist about this so that he can examine the condition of the scar on an ultrasound scan. He can advise some pain-relieving and softening ointment.

You need to understand: the healing of the suture after a cesarean section is very individual, it happens for everyone in different ways and depends on many factors: the process of childbirth, the type of incision, the state of health of the mother, proper care in postoperative period. If you keep in mind all these nuances, you can prevent many problems and avoid unwanted complications. After all, at this stage it is so important to give all your strength and health to the baby.

A caesarean section is a major abdominal operation. With it, not only the skin, subcutaneous tissue and the muscle layer underlying them are dissected, but also a large muscular organ - the uterus. These incisions are quite large, because obstetricians need to comfortably remove the baby from the uterine cavity, and do it very quickly.

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? All cut tissue heals differently. It depends not only on the individual characteristics of the body, but also on the state of health at the time after childbirth, on the age, on the physique of the woman, and on which incision was performed: longitudinal or transverse.

A longitudinal incision is more convenient for obstetricians in the sense that through it it is faster to get to the uterine cavity and get the baby. It is used in cases where there is a threat to the life of the mother or child: fetal hypoxia, bleeding in the mother, eclampsia in the mother. Doctors did it, got the baby out, handed it over to neonatologists or resuscitators, and then they stop the bleeding, remove the placenta, calmly and carefully sew up the cut tissues.

The seam after a longitudinal incision heals for about 2 months, but is felt and can periodically disturb during the year, sometimes longer. Such sutures tend to become thick and cosmetically unsightly.

A transverse incision in the lower abdomen is made in a larger percentage of cases, mainly after a planned caesarean section. The skin is often sutured using atraumatic suture material, and the thread passes intradermally, that is, there will be no traces of the needle on both sides - it will look like a neat thin line (in case you do not have an increased tendency to form keloid scars).

The seam after the transverse incision heals a little faster. As a rule, it is about 6 weeks. But it also tends to flare up for a year after a caesarean delivery. If the seam is inflamed after a cesarean section, do not tighten it.

Sutures on the skin are mainly superimposed with non-absorbable material - silk or nylon. These sutures are removed one week after the caesarean section. Of course, suturing with absorbable threads also takes place. Such threads dissolve themselves within a month or two (depending on the material).

After the operation, in the first three days, the seam hurts a lot. In the maternity hospital, a woman is given painkillers, so it is impossible to breastfeed during this period. If you want to establish then breastfeeding, then it is worth pumping to stimulate the production of milk in the mammary glands.

The seam is processed after a caesarean section with a 70% solution of ethyl alcohol with 0.05% chlorhexidine, 5% alcohol solution of iodine or brilliant green by the medical staff of the maternity hospital. A sterile bandage is applied to it. Before discharge, you should be told that upon returning home, you will need to carry out the same manipulations on your own: soak (while it still sticks to the skin) the old bandage, water it with peroxide, remove and treat with alcohol, and then brilliant green.

The treatment is usually carried out up to 7-10 days, then the seam can be smeared with sea buckthorn oil or Solcoseryl so that it heals faster and is less disturbed by pain pulling in it.

The suture on the uterus is completely scarred two years after the operation. It is after 2 years, not earlier, that a woman can plan her next pregnancy in order to be calm about the fact that the seam on the growing uterus will not open.

If you were discharged home, and the suture suddenly began to hurt more, if yellowish or bloody issues if a seal appears under the seam or the temperature rises - urgently contact the maternity hospital where you were delivered in this way - the obstetrician on duty will look at you at the emergency room and tell you what happened and how to deal with it.

A caesarean section is a surgical intervention to remove the fetus from the body of a pregnant woman when it is impossible to give birth on her own or for medical reasons.

The operation can be prescribed urgently when labor has already begun or as planned - before the onset of contractions. Depending on this, the surgeon chooses one of the 2 main types of caesarean section, which differ in the type of incision, the features of the suture and the postoperative period.

The technique of caesarean section has about 10 methods. If we consider these techniques in terms of consequences for the mother and the course of postoperative rehabilitation, There are 2 main methods:

1. In case of an emergency section or certain indications, the doctor performs an isthmicocorporal laparotomy with a lower median incision - it opens the skin, subcutaneous adipose tissue, abdominal muscles and tendons, peritoneum and uterus, making a vertical incision from the navel to the pubic region.

In some cases (corporal laparotomy), the incision may continue above the umbilicus. After the extraction of the fetus and placenta, a multi-level suture is applied - first, the walls of the uterus, peritoneum are sutured, then the tendons and muscle part, subcutaneous tissue and skin. The operation lasts up to 60 minutes, the mother's blood loss is up to 800 ml.

Seam features:

• seam length from 10 cm and more;
• the seam is nodal (not cosmetic), over time it turns into a fairly thick and dense scar;
• recovery period 2 months;
• disturbing phenomena in the suture area (pain, coarsening, as well as phenomena requiring qualified intervention) can be observed up to 2 years after the operation;
• to restore the aesthetic appeal of the abdomen, women have to resort to special cosmetic procedures to reduce the seam.

2. With a planned caesarean section, the surgeon performs a Pfannenstiel laparotomy - cuts the skin horizontally in the area of ​​the suprapubic fold (at the level of the bikini line; an incision just above or below this line is used for a similar Joel-Cohen operation), pushes the muscles and bladder, makes an incision in the lower part of the uterus and removes the baby.

Then the uterus is sutured, and a continuous intradermal suture is made on the skin. The operation lasts 20-40 minutes, blood loss is about 500 ml.

Peculiarities:

• seam length is usually up to 10 cm;
• no risk incisional hernias and muscle defects abdominal wall;
• less risk postoperative complications;
• it is allowed to sit down a few hours after the operation, it is recommended to get up no later than a day later;
• the recovery period is about 6 weeks;
• the scar is cosmetic, small, resolves within 6-8 months.

Suture care in the maternity hospital

With the normal course of recovery processes, the processing of the seam ends with an extract from the maternity hospital. If there are any non-dangerous pathologies, the doctor at discharge will tell you about the features of caring for the suture at home.

The stationary course of treatment includes 1-2 daily antiseptic blotting and rubbing, and in case of complications, the application of ointments and treatment of the wound edges.

Popular preparations used for seam treatment in stationary and at home conditions

The range of medicines for the care of postoperative sutures is quite extensive, however, in hospital practice and the recommendations of prescribing doctors, there are usually only a few items that are most optimal in terms of therapeutic efficacy and economic benefits.

Vishnevsky ointment

Balsamic liniment according to Vishnevsky - effective and inexpensive drug for the treatment of suppurating inflamed closed wounds. The ointment has not only a pronounced antiseptic effect, but also enhances blood circulation in the area of ​​application, contributing to wound healing.

The warming effect, as well as the restriction of oxygen access to tissues, limits the use of the drug on open and inflamed wounds and in the first 4 days after surgery. You can not use the balm with intolerance to birch tar, castor oil and xeroform.

There are also hypotheses about the possible carcinogenic effect of the components of the drug. But sometimes Vishnevsky's ointment is applied to a sutured, fresh wound after surgery for lack of other means. In hospitals, the balm is applied to the seam with a swab 2-3 times a day for the first week.

Chlorhexidine

Chlorhexidine bigluconate 0.05% is an effective and inexpensive modern antiseptic that has replaced the traditional "brilliant green" and its analogues. Chlorhexidine does not cause pain and chemical burns of an open wound, has a liquid fluid consistency, therefore it is used to wash and clean not only the adjacent areas, but also the suture itself.

However, sometimes Chlorhexidine causes irritation of the skin, mucous and open tissues of the wound. The action of the drug extends to a fairly wide range of bacterial, viral and fungal agents, as well as protozoa. Chlorhexidine does not cause addiction in pathogens.

Bepanthen

Bepanthen, Panthenol and other ointments based on pantothenic acid (vitamin B5) are not antiseptics, but they contribute to the activation of tissue regeneration, so they are recommended to be applied to the suture site for its speedy healing.

There are options for the drug with the addition of some kind of antiseptic (Dexpanthenol with chlorhexidine, Bepanten Antiseptic and others).

Zelenka

For the treatment of the skin adjacent to the incision, a solution of brilliant green alcohol 1% is used. The area around the wound with a width of 3-4 cm is lubricated 2-3 times a day for 2-3 weeks after surgery. In the presence of small bloody outflows by the time of discharge or when they resume some time after returning home, treatment continues on an outpatient basis.

Other drugs

Sometimes less common suture care medications are found on the prescription list, showing similar, and sometimes even greater effectiveness.

home care

The suture processing and monitoring activities continue after discharge from the hospital and include several important points that must be observed despite the mother's workload with household chores and child care.

Protective mode

A woman who has undergone a caesarean section should not lift weights over 3 kg, bend over and squat for a month. It is necessary to refrain from sexual activity for at least 2 months.

Lactation

Seam processing

Suture after caesarean section at home is necessary daily
process with the means recommended at discharge until the expiration of the ichorus (usually this is up to 2 weeks).

Diet

For the prevention of seam divergence and support of the immune system responsible for the fight against possible infections You need to follow a postoperative diet. The well-established work of the gastrointestinal tract after operative obstetrics protects the woman's body from intoxication with fermentation and putrefaction products.

A special diet is designed to reduce the risk of intestinal paresis and intestinal obstruction.

After daily postoperative fasting, patients are allowed light broths and unsweetened yogurts. After the first discharge of gases and within a month, boiled, baked, stewed and steamed dishes from lean meat and vegetables, buckwheat, oatmeal, millet and barley porridges are offered.

A week after the section, a little raw fruits and vegetables of green and white color are introduced into the diet - sources of vitamins, minerals and fiber. In addition, cereals, wholemeal bread, fruits, vegetables, vegetable oils and prunes regulate intestinal motility well. Dairy products indispensable for the restoration of intestinal microflora.

For the first 3 months, fast food, smoked meats, canned food, pickled foods, mushrooms, pastries, chocolate, fried and fatty foods are excluded from the diet; in order not to provoke constipation, it is advisable to abstain from rice and potatoes. Food should be eaten in fractional portions 5-6 times a day and drink plenty of water. In the future, the diet is adjusted to the needs of the baby during breastfeeding.

Bandage

After an operative delivery, women are strongly advised to wear a special postpartum bandage or model for those who have undergone abdominal surgery.

This device protects the seam from divergence and creates optimal conditions for tissue fusion, protecting the incision site from muscle tension, which can be caused by carrying a child in her arms, bending over and even breastfeeding. By reducing the mobility of fused tissues, the product contributes to the formation of a neat scar.

The bandage helps to avoid stretch marks (stretch marks on the skin), provides the necessary compression for the muscles stretched during pregnancy, and helps to return the stomach to a flatter shape. The wearing of this remedy plays a significant role in order to reduce the uterus and prevent back pain.

After corporal intervention, the bandage minimizes the risk of:

The optimal models for recovery after caesarean section are a universal bandage and a belt with rigid fixation. Models in the form of panties or skirts should have a high waist, a rigid insert on the stomach, and the fabric of the product should completely cover the seam.

It is not allowed to use a product of a smaller size, excessive pulling of the torso, redness and swelling of the skin due to impaired blood supply.

When using a bandage, it is necessary to ensure that the fabric of the product does not injure the seam and, if necessary, apply elastic bandages or pads. It should be put on in the morning in a prone position and removed only for sleep, water and air hygiene procedures which takes approximately 20 minutes every 4 hours.

If there are no complications, it is possible to put on a bandage or supporting fabric one day after the operation. It is recommended to wear the product for 3 to 6 months after the operation..

Contraindications to wearing the device are inflammatory complications in the suture area (discharge, redness, soreness, suppuration, fistulas), skin rashes under the bandage area, swelling and severe pain in a stomach.

Bath procedures and personal hygiene.

A week after the operation (after removing the threads) and until the suture heals, it is recommended to take a non-hot shower daily.

The wound area should not be rubbed with a washcloth and rendered mechanical pressure when drying: the place of the scar is washed with water and mild baby soap or an intimate hygiene product, and moisture is removed by blotting with a disposable or clean towel, the seam is treated with an aseptic agent (for example, Chlorhexidine with protection of the near-seam area with “greenery”).

Bath, bath, sauna, swimming pool and swimming in open water until the end of the recovery period (about 2 months) are prohibited.

It is necessary to monitor the cleanliness of the external genital organs and hands. It is ideal if a woman has the opportunity to wash herself after each visit to the bathroom, but it is necessary to wash her hands with soap after using the toilet, walking and communicating with animals.

Air baths.

The seam after caesarean section heals faster under the influence of ultraviolet direct sunlight and fresh air.
Sometimes ultraviolet irradiation of the seam is practiced in hospitals until the woman in labor is discharged and continues on an outpatient basis in physiotherapy rooms. Taking an air bath at home, you should avoid physical stress during the session.

Home activities that speed up suture resorption

You can start taking steps to prevent coarsening of the suture 1-2 months after the operation in the absence of complications.

Ways:

• a solution of vitamin E (alphatocopherol acetate), applied to the scar itself;
• gel and ointments Contractubex, Derimatix and their analogues are recommended by manufacturers for use immediately after removal of sutures, but their effect on the health of a child during breastfeeding has not been clarified. To some extent, Vaseline and moisturizing creams contribute to the reduction of the scar.

Physiotherapy

After the operation, lying on the stomach and breathing exercises with the stomach are shown. 2 months after the caesarean section (when the suture softens and the ligature resolves), you can contact a specialist in physiotherapy exercises to compile an individual set of exercises that are designed to accelerate the healing of the incision site and strengthen the abdominal muscles.

As a rule, these are classes with a hoop, a Kegel complex, lightweight exercises for retracting the abdomen and body turns, lifting and rotating arms and legs. Exercise therapy is designed to accelerate the scarring of the uterine and other internal sutures, so it should not be neglected, but if pain or complications appear, the start date is postponed.

How many heal when the stitches are removed: description by month

The course and duration of suture healing after caesarean section depend on the type of incision used during the operation.

Monthly description of external sutures for normally ongoing healing:

When should an ultrasound scan be done?

Ultrasound examination of postoperative sutures can be planned or prescribed based on the patient's complaints.

Features of the recovery period

The recovery period after a cesarean section is the healing time of the external suture, which is about 2 weeks (one of which falls on a hospital stay).

Pain and itching

Severe pain is observed in the first week after caesarean section. Normally, pain sensations of varying degrees persist up to 2 months after surgery, itching - up to 3-4 months. Separate disturbing painful phenomena can be observed in the first 12 months, especially with changes in atmospheric pressure and weather changes.

Stationary methods of pain control include intravenous or intramuscular injections of non-narcotic analgesics, taking into account the breastfeeding regimen, applying cold to the uterus and breastfeeding for the fastest contraction of the uterus, then warming up.

At the outpatient stage, the doctor informs about safe drugs for pain relief at discharge, you can also contact the observing gynecologist or pediatrician. Moderate physical activity also helps relieve pain.

A suture after a caesarean section can be itchy. This phenomenon indicates the ongoing regeneration and does not require intervention. Feelings of itching can be relieved by gentle stroking movements, but not by rubbing.

If there is a burning sensation, pain is accompanied by reddening of the scar, swelling and temperature, or deep pulling pains in the lower abdomen are observed, which are sometimes accompanied by vaginal discharge, then it is imperative to seek medical advice.

Serous discharge.

Serous expiration is the secretion of clear lymph and ichorus, which should end 1-2 weeks after suturing. If they continue, intensify, and also if blood appears in the discharge, a doctor's consultation is necessary.

In the normal course of the recovery period, the following should not be noted:

• severe bleeding from the external seam and vagina;
• opaque discharge with a smell;
• redness and swelling of the seam;
• increase in body temperature.

Early Complications

Early complications are various adverse effects of the operation that occur during the hospital stay. If one of the following phenomena occurs, you should immediately contact the medical staff of the hospital.

Bleeding

The cause of external (from the incision zone) and internal postoperative bleeding, subject to properly performed medical manipulations, may be disturbances in the work of the patient's blood coagulation mechanisms, as well as concomitant diseases, such as diabetes or obesity.

Bleeding from the external seam can occur due to:

• excessive muscle tension;
• stretching of the skin on the abdomen;
• sloppy medical manipulations when processing and changing the bandage;
• improper connection of blood vessels during surgery.

Uterine bleeding (lochia) with an admixture of mucus is natural within 2 months after the operation, but their abundance should decrease after a week, and the color normally ceases to be bright red. The discharge should not be clear, watery with an unpleasant odor, purulent, and black discharge with an unpleasant odor is also a concern.

With abundant or recurrent bleeding from the incision area or from the vagina, the woman is extended the recovery period in the hospital, the suture is checked and processed, intravenous infusions and iron and vitamin preparations and metroplasty can be prescribed.

Hematoma

Hematoma is a hemorrhage from insufficiently strengthened blood vessels under the skin during surgery. Other causes of hematoma may be early or inaccurate removal of sutures.

Disposing factors are diseases:

• kidneys;
• of cardio-vascular system;
• blood (for example, anemia);
• varicose veins veins.

Internal hemorrhage is characterized by a feeling of heaviness in the perineum. Depending on the location and extent of the hematoma, the doctor decides on the conservative or surgical removal of the complication.

Suppuration

Inflammation and suppuration of the suture occurs when a bacterial infection develops on the dissected tissues when especially viable strains of the pathogen enter the wound or when there are malfunctions immune system female patients.

Wound abscess begins with redness, pain in the suture area, accompanied by fever, chills, loss of strength and outflow from the wound of a cloudy sticky exudate with an unpleasant odor.

Treatment includes a course of antibiotics and treatment of the scar with antiseptic agents.(Vishnevsky ointment, Levomekol, Synthomycin emulsion and others), with a serious complication - drainage. To prevent suppuration from the second day after surgery, it is necessary to get up (gradually, without jerks) and follow the prescribed antiseptic treatments.

seam divergence

The seam after a caesarean section may diverge due to several reasons. The opening of the edges of the wound occurs due to the excessive physical activity of the woman in the first days after childbirth, active sports and weight lifting in the future, as well as due to the infectious process in the wound tissues.

Sometimes the discrepancy is caused by excessively tight underwear or underwear made of coarse fabrics. Dehiscence of the wound is sometimes observed after the removal of sutures and often in women whose child weighs more than 4 kg.

Late Complications

Late complications of suture healing are events that occur after discharge from the hospital, usually within 12 months after surgery.

Seromas

A seroma is a blister-like cavity at the suture filled with lymph. Seromas occur in the first weeks after the intervention due to the filling of dead-end parts clamped as a result of the operation. lymphatic vessels and are not pathological. But to differentiate a seroma from a fistula, a medical consultation is necessary.

Ligature fistula

A ligature fistula is a breakthrough in the place of suppuration of the suture material, when a bacterial infection develops on the surgical threads (ligature). A fistula may also appear as a result of allergic rejection of the ligature.

First, any area on the seam becomes hot, reddens, thickens and swells, pain appears, then the seam opens in one or more places and pus flows out, the general temperature rises.

The breakthrough site is a through passage through which air can circulate with noise (hence the name of the complication). Self-opening of the suture allows part of the rejected material and purulent contents to come out, however, it indicates a dangerous inflammatory process that requires immediate medical attention.

The initial stage of inflammation is treated conservatively - by the method of aseptic processing or drainage and with the help of antibiotics. But sometimes the infected ligature has to be removed surgically, while the wound is cleaned of exudate, a new suture is applied using other materials, and a course of antibiotics is prescribed.

The decision on the scale of the operation and the need for excision of the fistula is made by the doctor. External treatment of the wound with aseptic agents at home is insufficient.

If the fistula closes on its own after separation of the infected material, inflammatory process continues and relapses can occur, intoxication of the body continues, dangerous with the risk of inflammation of the peritoneum and internal organs and other consequences.

Keloid suture

After a corporal caesarean section, keloid (colloidal) coarsening of surgical sutures is most often observed as a result of hereditary predisposition and is an overgrowth of dense connective tissue containing collagen. Scars protrude above the surface of the skin, change color, and can cause pain and discomfort.

Hypertrophic scars do not go beyond the seam and are usually painless, keloid scars grow more extensively. Tissue changes can occur as soon as a month after surgery and persist for many years, although stabilization usually occurs for a period of 24 months after the onset of modifications.

Such a scar usually does not cause much concern, except for aesthetic, however, if the seal becomes inhomogeneous, bumps or discharge appear, you should definitely consult a doctor. The specialist will refer you for an ultrasound examination and help eliminate inflammation, ligature fistula and malignant degeneration of tissues in the area of ​​the scar.

Hernia

Hernia occurs after excision of the tendons of the abdomen during corporal laparotomy as a result of overexertion during heavy lifting, frequent constipation, or slow digestion and may be diagnosed many years after surgery. Small hernias require the use of a bandage, large hernias require surgical reduction.

The seam broke after a cesarean section: symptoms and actions

The most obvious are the symptoms of the divergence of the external (skin) suture, which are observed more often in the first month after the operation. More dangerous is the failure of the suture on the uterus, the duration of scarring which lasts for 2 years.

Signs of divergence of the uterine suture:

• pulling pain in the lower abdomen;
• increased body temperature;
• bleeding from the vagina, especially renewed or intensified a week after the operation.

The only right decision in this case should be an immediate visit to the doctor.

Symptoms of the divergence of the outer seam:

The seam must be treated with Chlorhexidine, applied sterile dressing, keep calm and call a doctor. If the suture does not diverge much, then re-suturing is usually not required and treatment is limited to local tightening. With suppuration, drainage will be required.

How to get rid of a scar: effective methods

The need to resort to correction of the scar arises both if a woman wants to improve the cosmetic appearance of a skin scar, and for medical reasons if a uterine scar is suspected of failing (“niche” in the suture area on the uterus).

Metroplasty: efficiency

Metroplasty after caesarean section is the imposition of a second suture on the uterus with the insolvency of the previous scar. The operation is performed by an open method (laparotomy) or through laparoscopic openings.

The need for metroplasty usually arises after:

• emergency caesarean section;
• inflammatory complications in the area of ​​the uterine suture;
• surgical termination of pregnancy up to 2 years after the previous intervention;
• early onset after the section of pregnancy.

With insufficient effectiveness of home methods of dealing with a rough external scar, discussed in the paragraph " home care”, you can turn to plastic surgery and massage. The methods are applicable to fully formed scars (approximately 12 months after surgery).

Grinding: efficiency

In cosmetology, several methods have been developed for grinding skin sutures:

Massage: efficiency

The effectiveness of massage is lower compared to grinding, but it allows you to succeed on small seams or moderately soften coarse defects. Massage is carried out after complete healing with pressing movements several times a day for 5 minutes.

The surface of the seam and the skin of the fingers are pre-cleaned, to enhance the effect, moisturizing creams or special agents are used to soften the keratin. In parallel, massage will help break down excess fat, strengthen the abdominal muscles and tighten the skin.

Other techniques

Less effective conservative methods include cryoprocedures (exposure to liquid nitrogen), hormonal external therapy, ultrasonic polishing.

Plastic surgery

Surgical excision is performed on non-extensive scars in order to remove excess connective tissue.

tattoo

After the final healing of the seam, you can resort to the services of professional tattoo artists. Sometimes successful color and graphic solutions with the inclusion of a seam in the composition can completely mask the scar.

In addition, keloid scars are treated with silicone and zinc dressings, compression devices, injections of corticosteroids, 5-fluorouracil, interferon, electrophoresis. Scar irradiation, practiced some time ago, is no longer performed due to the risk malignant neoplasms.
When to plan pregnancy after caesarean section?

After the operation, it is highly recommended to refrain from conception. next child for at least 2 years, so that the uterus had time to form a full-fledged scar, the tissues around the seam acquired sufficient thickness and the bearing of a new fetus passed without complications.

Optimal time for the next pregnancy falls on 3-10 years after caesarean section. Provided that a horizontal sparing incision and a synthetic (or semi-synthetic) ligature on the suture are used at the previous operation, the pregnancy following the cesarean section can be safely resolved naturally.

Article formatting: Vladimir the Great

Useful video about caesarean section

Pros and cons of CS:

C-section. These two words are perceived differently by every pregnant woman. Someone thinks that this is the worst thing that can happen, because you really want to give birth yourself. And someone - that this is a miracle, thanks to which you can save the life of both the mother and the child. But even more important questions arise about the rehabilitation period - what does the stomach look like after a caesarean? Will the seam be visible? How fast does it heal? What exercises can be performed and when to start physical activity?

A site for moms, the site will tell you what and how to do if you give life to a small miracle with the help of a CS (caesarean section).

Every expectant mother tries to learn more about this process before giving birth. And, of course, one of important points is an understanding of the need for CS and its consequences for the woman's body. It is better to be ready for anything than to be in a situation where you do not know what to do and how to do it.

For those who received a planned CS, rehabilitation period passes a little easier, because they are ready for it psychologically. But there are situations when the COP is an emergency. In any case, preparing for childbirth, it is worth learning more about the operation itself and what awaits you after it.

We know that CS is a large abdominal operation, during which several soft tissues are dissected, which are then successively connected with sutures. Most of all, we are worried about the stomach after cesarean and the seam. At first, the latter delivers a lot of pain, so doctors recommend taking painkillers that will help you start moving and not experience severe pain.

The state of the seam on the abdomen after cesarean

In the first months, the seam will stand out brightly against the background of the skin of the abdomen, having a red or purple tint and will differ in relief. But do not worry, over time it will become lighter, smoother and almost invisible. During the healing period, numbness, itching, slight burning and tingling can often be felt in the area of ​​\u200b\u200bthe seam.

The seam on the abdomen after caesarean section can be superimposed with silk threads or self-absorbable. Silk threads are removed for 7 days after the operation, and such threads as catgut, vicryl or maxon resolve themselves over time. It usually takes from one to 3 months, depending on the type of thread.

The seam does not require special care. It is enough to carefully treat it with an antiseptic solution and apply comfortable self-adhesive bandages. To remove them, you can soften the bandages with warm water under the shower or using a damp sponge. This will help to remove them without discomfort.

To relieve stomach pain after caesarean doctors It is recommended to wear a bandage. It helps keep soft tissues the abdomen in a stationary state, which allows you to move without pain. The wound, both internal and external, is at rest, therefore it heals faster. And when feeding the baby, it is recommended to put a small pillow on the stomach after cesarean, which will soften the baby's touch and make feeding less uncomfortable.

One of sensitive issues with the stomach after cesarean are gases produced in the intestines. Their accumulation is due to the fact that during the operation, the doctor, in order to get the child, slightly shifts the intestines to the side. Plus, this is facilitated by the air that has got in from the outside, and the consequences of the action of anesthesia. To avoid discomfort, you should limit yourself to products that can cause additional education gases.

Possible problems after cesarean

As after any operation, CS can be accompanied by complications, in which case it is necessary to immediately consult a doctor.

• Feeling of pain in the place of the seam or inside the abdomen, which increases and does not subside.
• Profuse bloody or yellowish discharge from a seam.
• Temperature rise.
• Seam divergence.

Belly after cesarean and fitness

Recovery after a caesarean section varies from woman to woman. Much here depends on psychological perception, age, physique, etc. But on average, healing takes about 6 weeks.

The strength and elasticity of the abdominal muscles after cesarean will return gradually, so in no case should you load yourself immediately upon arrival home exercise. For the first 6-8 weeks, it is worth going out for a walk only accompanied by a loved one, since walking with a heavy stroller can take a lot of energy and put additional stress on the seam.

In the first months, it is important not to rush with physical exercises for the abdomen after cesarean and remember that in addition to the external suture, internal ones were also applied, and they also need time to heal. According to various estimates, this may take about a year.

But it is possible to carry out small workouts with a minimum load even 2-3 months after childbirth. By this time, it is already allowed to visit the pool - it can also help to lose weight after childbirth. In any case, for training to be effective, we must not forget that they should always be paired with proper nutrition and sufficient strength. After all, there will be little sense from a tired mother who does not get enough sleep both for the baby and for her own body.

Therefore, fitness trainers recommend undergoing the so-called fitness testing, which helps to determine the state of the body and develop your own set of exercises, just for you. Only then will it be truly effective. And you can do it at home too. The main thing is to know your level of stress, so as not to harm the body.

If you are planning a planned caesarean section or you just want to know more about the possible nuances during childbirth, try to get as much information as possible without unnecessary emotions. This will help you to be prepared for any situation and deal with it as quickly as possible, giving more attention (physical and emotional) to your baby.

Reading 6 min. Views 1k. Published on 10.10.2018

The topic of today's article is the care of the suture after a caesarean section. I hope that not only mothers, but also members of their families will read it. Caesarean section is a serious test for female body, and mommy will need constant help in both caring for the baby and caring for herself.

Caesarean section - what you need to know

There are situations when natural childbirth is difficult or impossible without risking the life of the woman in labor or the baby.

It could be:

• neoplasms in the uterus;
• placenta previa;
• incorrect position of the child;
• large child;
• maternal health problems.

In such situations, the doctor decides in advance to perform a caesarean section - removing the child through an incision in the uterus.

An emergency operation is also possible if there is a threat to the life of the child or mother:

• profuse blood loss;
• cessation of contractions;
• fetal hypoxia.

Types of surgical incisions

In the case of a planned procedure, the incision is made horizontally, along the suprapubic fold, without affecting abdominal cavity. Such an incision is sewn with a neat cosmetic suture, which becomes inconspicuous over time.

If urgent surgery is needed, a vertical abdominal incision is most often used. It is sutured with an interrupted suture, subsequently transformed into a protruding scar, which hardens and increases over time. Such a seam significantly spoils the appearance of the abdomen.

Of particular importance are the internal sutures connecting the incisions of the uterus, muscles and peritoneum. The outcome of future pregnancies depends on their imposition.

Therefore, it is worth asking the surgeon in detail about the features of the operation and the necessary care.

Seam processing rules

The resulting seam needs careful care, otherwise infection with the most unpleasant consequences is possible.

Care in the maternity hospital

In the maternity hospital, the woman in labor is under the supervision of medical staff. The suture is inspected daily, treated with antiseptics (Chlorhexidine, etc.), the sterile bandage is changed. Pain medications may be prescribed for severe pain.

The only task of the patient is to prevent wetting and mechanical damage to the wound. A postpartum bandage can help with this, which protects the scar, tightens the belly deformed by pregnancy, and reduces pain. But its wearing should be agreed with the doctor.

Thread removal

The cosmetic seam is performed with dissolving materials, it does not need to be removed. The knotted sutures must be removed.

Primary healing of the seam lasts 5-10 days. In the absence of any abnormalities, the surgeon removes the sutures. This short procedure is not so much painful as unpleasant.

home care

If the condition of the woman in labor and the baby does not inspire concern, after removing the suture, she is discharged. But it cannot be assumed that the woman is already completely healthy. It is necessary to carefully follow the recommendations that the woman in labor will receive before discharge. At first, she will need the help of loved ones. After discharge, the mother must:

• avoid physical overexertion, especially heavy lifting;
• avoid sudden movements;
• avoid prolonged lying, walking is very useful for recovery;
• process the seam with recommended means;
• 2-3 times a day, arrange half-hour air baths for the seam;
• wear a bandage that supports the stomach and prevents the seam from opening;
• the seam can be wetted, but you can not rub it with a washcloth;
• avoid any mechanical impact on the incision, do not wear squeezing and rubbing clothing;
• watch your diet - it is very important for a speedy recovery.

With normal healing, the need for treatment will disappear after 7-8 days. Regular examinations by a doctor are necessary, especially when complications appear.

Postoperative discomfort

Pain in the postoperative period is inevitable. And this is expected, given the severity of the operation. If the suture is very painful, the doctor may prescribe analgesics that are compatible with breastfeeding. Physical therapy may be prescribed. Doctors recommend movement, this helps the proper healing of internal injuries.

Usually the pain bothers 3-4 days, then subsides. Perceptible discomfort can persist for up to two weeks, sometimes longer. The pain may intensify and return after a long period after the operation with the vagaries of the weather.

After about 6-8 days, the seam begins to itch, which indicates its healing. It is necessary to refrain from scratching, after 2-3 days the itching will subside.

Scar formation and resorption

It takes about a month for the complete overgrowth of the seam after cesarean. At this time, you can use auxiliary means for resorption of the scar, but only after consulting a doctor. Usually, to lubricate the scar, use:

• vitamin E (capsules);
• Contractubex;
• Solcoseryl.

Complete scarring takes from a year to a year and a half, depending on the type of suture and the health of the woman. At this stage, after consulting a doctor, more radical measures can be taken to get rid of the scar: laser resurfacing and other cosmetic methods.

Complications after caesarean section

In most cases, with proper operation and proper care complications are avoided. But, nevertheless, as with any operation, they are possible. Unfortunately, problems can occur even after a few years, so the scar should be monitored.

Early Complications

Incorrectly sutured vessels, damage to a fresh suture, rough removal of sutures, and non-compliance with the rules of postoperative care can lead to their appearance. The following problems may occur:

• hematoma;
• the formation of adhesions;
• bleeding of the seam (not to be confused with the release of ichor, which is a normal process);
• the seam is festering;
• granulation (development at the seam of connective tissue in the form of swelling);
• puffiness;
• endometritis (inflammation of the uterine cavity).

With these or other alarming signs - fever, bouts of weakness, persistent pain - you should immediately consult a doctor. Only he can diagnose and prescribe treatment. Self-medication threatens with very serious consequences, up to a lethal outcome.

seam divergence

It's quite rare, but serious complication. During the first 7-10 days, it can be caused by a load on the abdominal muscles or an infection in the wound that prevents the incision from healing. If the suture has opened and started to bleed, apply a sterile dressing and seek immediate medical attention.

Late Complications

Complications that appear after a few months or later are classified as late.

1. Keloid scar. seam growth a large number soft tissues. It does not cause physical inconvenience, but is extremely unaesthetic. Deleted cosmetic procedures or surgically.
2. Ligature fistulas. The area around the suture threads becomes inflamed, a seal appears with oozing pus. The doctor removes the thread and pus, prescribes drug therapy.
3. Hernia. A rare complication, possibly with a second operation.

A caesarean section is a surgical intervention, complications after which may appear after a few months or even later. Be careful!

Pregnancy after surgery

There is no prohibition on childbirth after surgery, but it is necessary to take a very responsible approach to planning the next pregnancy. Full recovery of the uterus will take 2-3 years. Pregnancy in more early dates, like abortion, can lead to serious damage to the uterus. Therefore, reliable contraception is necessary for this period.

After a full recovery, pregnancy does not pose any danger. Often the problem of such a pregnancy is severe pain in the area of ​​the scar. The expectant mother has a well-founded fear that the seam has opened after a cesarean.

As gynecologists explain, the pain is not caused by a seam, but by adhesions stretched by a growing belly. It is necessary to report discomfort to the attending physician, who, if necessary, will check the condition of the scar on an ultrasound scan.

Conclusion

The happiness of motherhood is a worthy reward for the pain suffered during a caesarean section. But you must remember that your baby needs a healthy mother. Therefore, take care of yourself, follow all medical recommendations - and be healthy and happy! We are waiting for your comments!