Redness, tightness, pain … not always easy to know if the caesarean scar follows a normal evolution or if a complication is looming. Dr. Jonas Benguigui, obstetrician gynecologist, helps us to sort between reassuring signs and worrying symptoms.
What is a cesarean?
Cesarean section is a surgery which consists in incising the abdominal wall and the uterus of the pregnant woman to extract the baby. The cesarean can be recommended when childbirth by low route is considered risky. The scar is just above the pubis and generally measures fifteen centimeters. The staples or stitches made using absorbable wires are removed 5 to 10 days after the intervention.
How do I know if my caesarean scar heals correctly?
A caesarean scar on the right healing has several visual and sensory benchmarks. “”From the first post-operative week, the scar must be well closed, without oozing“, Specifies Dr. Benguigui. First red or purplish, she is gradually clearing himself.”The texture also changes: often thick at the beginning, it becomes smoother over time. “
The feeling of tightness or tingling should not worry either. They are linked to the small nerves cut during the intervention. “”These neuropathic pains are normal and can last several weeks or even a few months. The sensitivity at the level of the lower abdomen is gradually returning.“”
Pain, beads, adhesions, a stocky scar that pulls, scratch, flows, bleeds … When should you consult?
Even if some sensations can be annoying, certain signs should not be ignored. “”A persistent redness, a hot, painful, purulent scar or the appearance of fever greater than 38 ° C must alert“, warns the specialist. These symptoms may indicate an infection or an abscess, requiring rapid management. Rising pain, instead of fade, must also motivate a consultation.
Another potential complication: internal adhesions, which can cause chronic pain. Their diagnosis and treatment require gynecological follow -up.
How to alleviate the caesarean scar?
A beautiful healing depends at 80 % on the quality of the patient’s skin and 20 % of the suture itself, according to Dr. Benguigui. The first weeks, avoid baths and any exposure to the sun. “”You have to keep the area clean and dry, while tapping gently after the shower. “
Some products may promote better healing: emollient creams enriched with vitamin E, regular massages, silicone dressings. In addition to aesthetic care, these gestures also help to better experience a sometimes poorly accepted birth.
Also pay attention to the risk factors for poor healing: tobacco, overweight, or immunosuppression. They increase the risk of cheloid scar, a complication that may require specific treatments such as corticosteroid injections, laser or surgical recovery.
Retain
– A scar which becomes clearer and smoother is a good sign;
– Persistent redness, growing pain or flow must alert;
– The quality of home care plays an essential role in the final aspect of the scar.
How to treat and maintain the scar of cesarean?
At maternity, health professionals have watched over the care of the Caesarean wound. Once back home, you have to take over. The first days care is important for the future of the scar. “”You must already wash the wound, even if it is not beautiful and still oozes“, Advises Anna Roy. Savine with an intimate gel or Marseille soap, without rubbing too much, then dry by dabbing with a toilet towel dedicated to this use. Only a clean wound can heal correctly.
The cesarean wound remains alive for 15 to 20 days. “”It is good to have this wound watched by a midwife during the first three weeks“, Consulates Anna Roy. If it notes that healing is not done well, it can prescribe local care which makes it possible to improve the aesthetic aspect. After your delivery, health insurance takes care of the visits of liberal midwife. Take advantage!
Throughout this period, it is necessary at all costs to avoid scratching to limit the risk of infections and avoid sudden movements. Wait for your doctor’s agreement to resume physical activity.
Massage: When and how to massage the scar from Cesarean?
Once the scar no longer bleeds, No longer oozes, and has a well-consolidated aspect, that is to say, closed scar, it should be massaged every day to improve its appearance. This allows you to soften it and avoid adhesions that will form folds on the scar. It is essential to leave the scar in the open air.
In the morning, make small massages in small circles with your fingers on the scar, with a moisturizing and drying restorative cream (Calfate or Cicaplast type) and get back in the evening with an oil this time. This will continue to act during the night. Use an organic paraben oil and added products, for example a soft almond oil. These massages are to be carried out until the external appearance is satisfactory.
However, these automations do not act in depth. The intervention of a masseur-physiotherapist is therefore interesting, 6 to 8 weeks after childbirth. “”The goal of massages is to make flexibility and sensitivity to the entire scar. Massages also have an analgesic role“Explains Jean-Marc Stanislas. This work allows you to take off the adhesions in depth. The physiotherapist also aims to make the scar the most aesthetic possible.”These specific massages adapted to each scar alleviate imperfection and allow you to reach a scar that you do not feel“, informs the masseur-physiotherapist. An beginning of improvement is noticeable after 2 to 3 sessions and the final results are obtained in ten sessions. These can be carried out during abdominal rehabilitation sessions or outside.
Cesarean healing and recovery: some rules to respect
To prevent the heist from digging, you must give up low-waisted underwear! The elastic of these rub and press the scar, which leads to the formation of two beads, one above and below the scar. Rather, wear high -waisted pants or very low waist. During the first year following the cesarean, and especially in the first 6 months, do not expose the scar to UV rays, this is likely to pigment it.
If despite all these treatments, you are not satisfied with your caesarean scar, you can ask for a surgical resumptionbut on the condition of not wanting to baby anymore afterwards. If you want to have another baby, it is preferable to wait for the cesarean after to make you re-operate. Before embarking on an operation, you can try massage sessions at a masseur-physiotherapist: two or three sessions will allow you to see a start of improvement. If this is not the case, it is not worth continuing.
Is it normal for the caesarean scar to be swollen?
It is completely normal for the caesarean scar to be slightly swollen within 4 to 6 weeks depending on the intervention. This swelling is part of the healing process. The scar at the scar can also be sensitive, red or slightly tense. However, swelling should gradually decrease. If it increases, becomes painful, hot to the touch, is accompanied by a flow or fever, this can be the sign of an infection or a complication. Similarly, if a hard bump persists several months after the operation, it is advisable to consult to rule out causes such as a hypertrophic scar, hernia or a chéloid.