Many women are apprehensive about the entire process of giving birth. As doctors we are often asked questions such as “Will it hurt?”, “Is it painful?”, “Is it better to have a natural birth than a C-section?” Some mothers even insist on natural delivery as they fear that a C-section will leave behind an ugly scar.

However, Caesarean birth, or C-section, is common these days and is usually performed when a vaginal delivery would put the baby's or mother's life or health at risk. Recent studies show that about 25 per cent of mothers go through C-Section in many Asian countries including India.

The biggest myth that goes against a C-Section delivery is that it will leave behind an ugly scar. The scar (or suture line) will be about 15-20 cm long. Occasionally, the scar may be near the centre of the belly (especially if it was an emergency or a premature baby). Often these scars appear crooked or uneven; however this usually improves over the months. Contrary to misconception, the scar is not the result of an infection but forms when various layers of skin and tissue are rejoined.

Fortunately, modern procedures leave much smaller scars thanks to innovative ways of closing the incision. Today surgeons use a minimally invasive system of Caesarean delivery that requires short operating time, minimal instrumentation, reduced surgical dissection, and reduced infection and wound complications.

Latest techniques

Steri-strips are adhesive material used to help the edges of the incision grow together. The advantages include low rates of infection, speed of application and ease of removal. Steri-strips curl and peel away from the body, usually within five to seven days after surgery. They can be pulled off after two weeks if they have not fallen on their own.

Liquid tissue glues are applied to the edges of the incision and form a bond that holds the tissues together until new tissue is formed. In addition to speed of use and a low infection rate, tissue glues are gradually absorbed by the body. They are less likely to cause scarring but are more commonly used in facial surgeries or other cosmetic procedures rather than for C-Section.

Incision care in hospital

After a caesarean delivery, incision care refers to a series of procedures and precautions related to closing a wound or surgical incision; protecting the cut or injured tissues from contamination or infection; and caring properly for the new skin that forms during the healing process.

Incision care begins in the hospital and is continued by the patient during recovery at home. The reasons for incision care include:

lowering the risk of postoperative complications, particularly infection

avoiding unnecessary pain or discomfort minimising scarring preventing blood loss

Dos and don'ts after surgery

It is normal for the scar to itch while it's healing. This shows that the body is beginning to knit itself back together.

Resist the urge to rub or itch! You could tear it open, causing excruciating pain and a trip back to the doctor to start all over again.

Pat the wound dry with a clean towel after bathing or showering. Use lotion or cream to soothe the area.

Try to avoid applying talcs or creams until the scar is well healed. After about 10 to 14 days you may apply Vitamin E or Calendula cream to help the healing of the scar.

The scar will appear dark and/ or a deep purple, before turning pink and finally fading to white after a few months.

The author is Professional Services Consultant, 3M Healthcare, 3M India

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