We have already spoken several times about caesarean section and the implications of this abdominal surgery on the body and the health of women.
Many are the care that is required after the operation, not only externally - that is, aesthetically - but also internally. Today we tell you what care recommended by the midwife perform after caesarean section
Immediate wound care
During the caesarean section, the deepest layers of the skin are sewn by resorbable material that our body assimilates with the passing of days. The visible tissue, that is, the skin, is sewn with different techniques such as staples, non-absorbable loose spots, intradermal suture ...
After the operation, the most important during the first days are the superficial care that the wound requires. These cares include:
Wound hygiene: you have to wash it with soap and water daily, avoid using sponges that can get caught in the staples or in the seam and dry it very well with light touches, helping us with a sterile waste.
In some hospitals it is also advised to use a antiseptic to heal the wound after bathing, but it is important to know that if you have chosen to breastfeed you should avoid solutions with iodine as they pass the baby through breast milk.
It will not be necessary to cover the wound with no dressing, unless the doctor or midwife has advised you otherwise.
We must prevent clothes from pressing, rub or may get caught in the scar.
Wound care after stitch removal
After approximately ten days, the wound will have healed and proceed to remove stitches or staples in the consultation of the midwife or the gynecologist.
Sara Cañamero, midwife and director of the MaterNatal center, recommends that once the stitches have been removed, the woman gets a daily massage on the wound with rosehip oil. Rosehip will help not only to hydrate the area, but to regenerate the tissue and, in the long term, to disguise the scar and reduce the volume.
“The objective of these superficial massages is to increase the vascularization of the area, in addition to decreasing the probability of keloids and adhesions” - says Sara.
When you no longer have stitches or staples you will feel great relief in the wound. You will notice less tightness and the itching will probably decrease or even disappear. However, you will experience new sensations such as numbness and some discomfort when you touch the abdominal areaRafael Vicetto, physiotherapist and director of the Vicetto clinic, insists on Sara's advice:
"Touching the abdomen and gently massaging the wound every day will help to eliminate tension and the area gradually regaining sensitivity."
Wound care after quarantine
And we must not forget that caesarean section is a major abdominal surgery and that the post-surgical care required is many. So, according to experts, they should not stay exclusively in the first few days“After the quarantine - approximately six weeks - midwives recommend going to a specialized postpartum center to assess the scar. Health professionals will check that it is evolving correctly and will set guidelines for rehabilitation”- says Sara Cañamero.
In a surgery, as is the case with caesarean section, different planes of tissue are cut and then sutured again. Sometimes, the suture produces internal tensions that prevent normal movement of both muscle and abdominal fascia.
“Few women know that the incision should be treated beyond the basic care of the principle. Perhaps midwives should insist more on this in the childbirth preparation classes, or perhaps the lack of knowledge is also due to the low importance that other medical partners give to the subject ”- Sara reflects.
“The treatment of the scar does not happen by putting on silicone patches to improve aesthetics because a scar goes much further. We could say that what we see is the tip of the iceberg. In consultation we are treating women - who are already at menopause - of problems caused or aggravated by this injury not treated at the time by a physiotherapist" - alert.
Physiotherapeutic treatment of adhesions
The midwife explains:
“Untreated scars give short, medium and long term problems. And we not only talk about aesthetic problems, but about more serious ones such as adhesions, which have an impact on women's health affecting the internal organs, pelvic floor problems, backaches, a bad birth in the future and a long etcetera "
“It is necessary to put yourself in the hands of a specialized physiotherapist to check the scar and work it in its different planes ”- he advises.
In the words of the physiotherapist, Rafael Vicetto, adhesions in different tissue planes affect not only the uterus but also the abdominal muscles and connective tissue, causing different symptoms ranging from:
Constant pain in the scar area and surroundings
Discomfort in sexual intercourse
Stress in the abdomen and hypersensitivity to touch
Discomfort with tight clothing or underwear that rubs the scar ...
As the midwife told us, the physiotherapist's work will be carried out in two planes:
A superficial plane: where the tightness of the scar is treated, the thickening of the scar (keloid), its hardness or retraction.
A deep plane: in which one works by mobilizing the structures and parts of the body that have been affected by the scar.
Rafael advises these three physiotherapeutic techniques for the treatment of the scar:
Manual lymphatic drainage techniques: which is done with the hands through very soft, slow and repetitive movements that favor superficial lymphatic circulation thus improving inflammation and fluid retention
Kinesio tape bandage: help in the treatment of edema or large swelling caused by surgery
Indiba technique: It consists of the abdominal application of local heat under the influence of an electric or magnetic field, which helps reactivate the internal circulation. This technique relieves pain and improves oxygenation and tissue regeneration.
And once the treatment is finished, what can we expect?
Once the adhesions and possible problems derived from the intervention have been eliminated, the woman's abdomen will be healthy and preparing to face a new pregnancy.
In any case, it is important to know that whether it has been given birth vaginally or if it has been a C-section, WHO does not recommend a period of less than two years between pregnancies and, in any case, never less than 18 months for the risk of premature delivery and other problems for the mother.
Therefore, the work of the midwife together with that of the specialized physiotherapist, are essential for the recovery of the caesarean section is complete at all levelsISotck photos
Clinical Source of Physiotherapy Vicetto, Sara Cañamero, midwife
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