Seam on the uterus after caesarean section. Postoperative complication Painless bump on the seam after caesarean section

A cesarean delivery is a surgical procedure in which the baby is removed through an incision in the abdomen. lasts from 3 to 6 months. As the uterus heals, a scar forms. Problems with the seam after caesarean section occur quite often. They are provoked by poor-quality care, violation of the principles of the operation, infection, etc.

Important! If a seal has formed over the seam after cesarean, you should immediately consult a doctor to identify the sources of the pathological process.

Causes of seam sealing after caesarean section

Surgical manipulations involve suturing the soft tissues of the abdominal cavity using medical instruments. The choice of material is carried out on an individual basis, depending on the type of operation.

After surgery, the suture is gradually covered with connective tissue, which leads to the formation of a scar. Under the influence of certain factors, the scar is formed incorrectly. This is manifested in redness of the skin and the appearance of a seal. Possible reasons for this phenomenon include:

• appearance;
• tissue infection;
• the formation of a purulent process;
• autoimmune response of the body.

Most often, after a caesarean section, the seam is hard due to infection in an open wound. Poor hygiene during the recovery period or neglect of the recommendations of a gynecologist can provoke a problem. The first time after childbirth may require a reception. If the seam is hard and hurts, required urgently visit a specialist. This situation requires timely treatment.

Types of caesarean section sutures

Complications after a surgical procedure can affect any type of suture. In medicine, they are divided: internal, horizontal and vertical sutures. In the first case, we are talking about those that are superimposed directly on the area of ​​\u200b\u200bthe uterus. Methods for applying medical threads are different.

The doctor focuses on the need to prevent bleeding and ensure the woman's ability to bear in the future. When carrying out a laparotomy, it is customary to make a transverse suture. When conducting a corporal operation, the most relevant is the longitudinal internal one. The uterus is sutured with synthetic strong threads, which dissolve on their own over time. After that, stitches are made on the abdominal wall.

Vertical
Transverse

The vertical seam starts from the pubic area and ends at the navel. It is applied at a high risk of hypoxia in a child and profuse blood loss in a woman. Such a seam is considered a significant visual defect. He has a penchant for curing in the future.

Most often, they seek to remove it by laser exposure or to do it. The horizontal seam is in the crease above the pubic area. Its physiological location makes it as invisible as possible. This method of tissue connection is preferred when the operation is without complications.

Why did a lump appear above the seam

The hardness of the skin at the site of dissection at the recovery stage is considered an absolutely normal phenomenon. If there is no pain signal and purulent masses, there is no need to worry. Soft tissue softening begins only one and a half years after surgical procedures. A bump on the seam indicates the development of a pathological process. In this case, you can not do without a visit to the gynecologist's office.

Do you have a vertical or transverse seam?

VerticalTransverse

Compaction in the form of any size bumps may precede the formation. Ideally, after a certain period of time after surgery, the stitches placed on the uterus should dissolve on their own.

If this happens for some reason, the inflammatory process begins. Purulent masses accumulate under the skin. After some time, a purulent head forms on the bump, through which dead leukocytes come out.

With a ligature fistula, a throbbing pain appears at the site of scar formation, the skin begins to turn red. Bursting sensations may be present. It is extremely important to see a doctor on time and start therapy.

Sometimes seals after cesarean section provoke violations of regenerative processes. In medicine, a scar caused by such a cause is called a keloid. It does not pose a threat to the patient, but is aesthetically unattractive, which causes psychological discomfort. Such a scar is recommended to be removed with a laser.

Another common complication of surgical procedures is seroma. It differs from a fistula in that it can disappear on its own.

Seroma- this is a pathological seal in the suture zone, inside which there is liquid content. It is formed at the site of crossing of the lymph nodes. It is almost impossible to sew soft tissues in this area after dissection. In this place, a cavity is formed in which lymph accumulates. After the discovery of seroma should visit a doctor to determine the cause of the pathology.

One of the early complications is considered. This usually occurs 7-10 days after surgery. The reasons for the divergence of the seam include lifting heavy objects weighing more than 4 kg and the transfer of infectious diseases. This condition is very dangerous for a woman's health. It is important to contact the surgeon and / or gynecologist in time to prevent complications.

Overt symptoms

After a caesarean section, the seam hurts anyway. Therefore, the pain syndrome is considered a subjective sign of the pathological process. Analgesics are prescribed to relieve pain. They are taken immediately after surgery. The duration of pain in the area of ​​​​the seam depends on its type. The transverse suture for complete healing requires no more than 6 weeks. The longitudinal seam stops bothering about 60 days after birth. Other symptoms of pathologies include:

• itchy sensations;
• purulent discharge;
• hardening of the seam;
• subfebrile or high body temperature;
• deterioration of well-being;
• seam bleeding.

The internal seam after caesarean section has a tendency to diverge. In this case, the woman has spotting. Since the first time after delivery, it will be difficult to understand the nature of the origin of the discharge. Their number will increase significantly. An unpleasant odor and blood clots may be present.

Excess body temperature- the main sign of inflammation in the body. The phenomenon is observed due to the fact that the immune system is trying to resist a viral or infectious disease. Subfebrile or elevated temperature is accompanied by a decrease in efficiency and chills.

Many women in labor are concerned about itchy sensations in the suture zone. In fact, they are completely safe, indicating that the wound is being healed by connective tissue, that is, it is healing. For severe itching Absolutely forbidden comb the seam. If there is a burning sensation, then you need to see a doctor.

When to be afraid

Have you already seen a doctor

YesNot

The development of complications can not be noticed immediately. At the very beginning, the clinical picture is blurred. By itself, a hard suture after a caesarean section is not dangerous.

It is necessary to pay attention to accompanying signs of deviations. Normally, the scar does not rise too much above the skin surface. Beside shouldn't be swelling and redness.

The accumulation of pus, open wounds, an unpleasant odor and throbbing pain indicate the development of inflammation. Should regularly inspect the seam and listen to your feelings.

But the most reliable way to diagnose is timely visits to the gynecologist. The doctor will be able to detect the problem with a visual examination. Particular care should be exercised a week after surgery. During this period, it is very easy to become infected.

What to do with complications, the doctor decides. Preliminary ultrasound is done to exclude the possibility of divergence of scar tissue. Tests are also taken to detect the presence of inflammation in the body. After collecting data, a treatment method is selected. Seam seal after cesarean disappears approximately 10-12 months after the operation. Otherwise, it is removed in a cosmetic clinic.

Treatment

The method of therapy for sealing on the seam after cesarean section is selected taking into account the cause of the pathology. For the healing of purulent formations, treatment involves the use of antimicrobial agents. The seam area is regularly treated with antiseptic solutions. Antibiotics are administered orally or by intramuscular injection.

According to statistics, the divergence of the scar is possible in 4-10% of cases. This is due to the anatomical features of the structure of the muscles of the abdominal wall in women. If the sutures diverge, a second operation is required. A uterine rupture is extremely dangerous for a woman's life, so you should not delay treatment.

The fistula is treated surgically. The main cause of the pathology is a medical thread stuck in the soft tissues, from which suppuration has begun. It can only be removed surgically. The surgeon opens the wound, removes the foreign element and gets rid of the purulent masses. After the operation, the woman is shown anti-inflammatory therapy.

A bump above the seam, not accompanied by an inflammatory process, may eventually disappear on its own. But in any case, it must be shown to the doctor. The need for treatment of a keloid scar is determined by the woman herself. Such a pathology delivers only aesthetic discomfort. The scar after caesarean section is removed by surgical excision or more conservative methods:

• chemical peeling;
• ultrasound treatment;
• laser removal;
• ointments on a hormonal basis;
• exposure to liquid nitrogen.

The most effective method of removing a postpartum scar is a laser procedure. It is characterized by the absence of pain and a high degree of effectiveness. After 2-3 procedures, there will be no trace left of the scar. The disadvantages of this method include high cost. In most cases, such an operation is performed in private clinics.

Means for topical use are based on hormones. Their use helps to make the scar less noticeable. The disadvantages of the method include the cumulative effect. To see improvements, you need to use the cream for a long time.

The surgical method of treatment has many opponents. During the operation, the scar tissue is completely excised. Then the scar is applied again. There is no guarantee that the situation will not happen again.

Preventive measures

The degree of risk of developing undesirable consequences after surgery depends on the quality of preventive measures. First preventive care is provided to a woman in labor immediately after surgical procedures. Factors that can provoke infection in the uterine area are eliminated. The abdomen after a cesarean section is periodically lubricated with brilliant green.

Stitches are removed after about 7-8 days. At this stage, the likelihood of complications is highest. After the end of the period of stay in the hospital, home care begins, which includes the following nuances:

1. It is strictly forbidden to lift weights and play sports.
2. In the presence of discharge from the scar, it is necessary to carry out regular treatment with an antiseptic solution. How to carry out the procedure correctly, the attending physician will tell you.
3. At first, it is recommended to wear it, which allows you to maintain the muscles of the peritoneum.
4. A month after cesarean, the seam is solid. This is considered normal, but at this stage, steps can be taken to soften it and heal quickly. For this purpose, special regenerating ointments and creams are used. It is often recommended to use Contractubex ointment.
5. Sexual intimacy at the stage of recovery of the body is strictly prohibited.
6. It is recommended to pay attention to nutrition during the recovery period. The presence of vitamin E in the diet helps speed up the regenerative processes.

The complication may go away on its own, but this does not mean that the problem should be ignored. Regular visits to the doctor will help to identify visible signs of abnormalities in time.

Doctors' opinion

Seal over the seam after caesarean section most often appears as a result of infection. The uterus at the recovery stage is extremely vulnerable to pathogenic microorganisms. Lack of hygiene and refusal of medications leads to suppuration of the wound. This is dangerous not only for health, but also for the life of a woman. If you do not consult a doctor on time, the following complications may follow:

• internal bleeding;
• uterine rupture;
• sepsis;
• fatal outcome.

In acute inflammatory processes associated with the appearance of pus, the help of a surgeon is necessary. Only a doctor will be able to exclude further complications by choosing the appropriate method of treatment. If nodules occur in the suture area after a cesarean section, you should immediately consult a doctor, even in the absence of other alarming symptoms. Help in the form of surgery in this situation is invaluable.

After the second and subsequent operations, the woman should again follow the recommendations prescribed by the specialist.

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Patients of surgical departments often note the unsatisfactory condition of the postoperative suture. Seals that occur in the first days and weeks after surgery usually disappear on their own and do not require additional treatment. Most often, such a temporary complication looks like a bump on the seam.

The reasons

To understand why there was a seal under the seam after the operation, you should see your doctor. If the bump does not hurt and pus is not released from it, you just need to follow the recommendations for caring for the suture and do not try to self-medicate. If even a meager purulent discharge is found, a visit to a doctor is necessary. Untimely adoption of measures or attempts to resolve the issue on their own can lead to serious complications, which can only be eliminated surgically.

The main causes of suppuration of postoperative sutures:

• Improper suture care, which can lead to a bacterial infection.
• Non-compliance with the recommendations given by the doctor upon discharge from the hospital.
• Poor quality stitching.
• Rejection by the body of the threads used to stitch the incision.
• The use of poor quality materials.

Whatever the reason for the appearance of the bump after the operation, you should not delay visiting the surgeon in the hope that everything will go away on its own. Suppuration can lead to sepsis and death.

Postoperative complications

Occur after any surgical intervention and are of varying severity. It all depends on how neatly the seams were applied and what materials were used. Mild complications go away on their own, but if a bacterial infection has joined in the healing process, the help of a surgeon is needed. Self-medication is strictly contraindicated due to the complexity of the wound and the risk of sepsis.

The most common postoperative complications:

• adhesive process;
• seroma;
• ligature fistula.

adhesive process

This is the name of the fusion of tissues during the healing of the postoperative suture. Adhesions consist of scar tissue and during palpation are felt under the skin as small seals. They accompany the process of healing and scarring of the sutures, being an integral, natural step on the way to the restoration of tissues and skin after an incision.

In the presence of pathology during wound healing, excessive growth of connective tissues is observed, the seam thickens. Most often this happens if the wound heals by secondary intention, when the process of tissue repair after surgery was accompanied by suppuration due to an attached bacterial infection. In such cases, keloid scars form at the site of suturing. They do not pose a health hazard, but are considered a cosmetic defect, which, if desired, can be eliminated later.

Seroma

Another complication that occurs after suturing. A seroma is a fluid-filled lump on a suture. It can occur as a consequence of caesarean section, and after laparoscopy or any other operation. This complication usually resolves on its own and does not require additional therapy. Occurs at the site of damage to the lymphatic vessels, the connection of which after the incision is impossible. As a result, a cavity is formed, which is filled with lymph.

If there are no signs of suppuration, the seroma on the scar does not pose a threat to health, but to make sure that there is no inflammatory process, it is worth visiting a surgeon who can make an accurate diagnosis.

Ligature fistula

This complication most often occurs on the seam after a caesarean section. For suturing, a special thread is used - a ligature. This material is self-absorbable and conventional. The duration of wound healing depends on the quality of the thread. If a ligature that meets all requirements was used during suturing, complications appear extremely rarely.

If an expired material was used or an infection entered the wound during suturing, an inflammatory process develops around the thread. Initially, a seal appears under the seam after a cesarean or other operation, and after a few months, a ligature fistula forms at the site of the seal.

It is easy to detect pathology. A fistula is a non-healing channel in soft tissues, from which pus periodically oozes. Depending on which infection caused the inflammation, the discharge may be yellow, greenish, or maroon-brown.

From time to time, the wound may be covered with a crust, which periodically opens. Purulent discharge can change its color from time to time. Also, the inflammatory process is often accompanied by fever and a feeling of chills, weakness, drowsiness.

A ligature fistula can only be removed by a surgeon. The specialist will find and remove the infected thread. Only then is healing possible. While the ligature is in the body, the fistula will only progress. After the thread is removed, the doctor will treat the wound and give instructions for further care of the suture at home.

There are cases when, with untimely seeking medical help, several fistulas formed along the seam. In such a situation, the surgeon may decide to perform an operation to remove the scar and apply repeated sutures.

Precautionary measures

After returning from the hospital, the patient must remember and follow a few simple rules that will help him recover faster after surgery. Basic Precautions:

• Don't take contrast showers. Sudden changes in water temperature slow down the process of skin regeneration.
• Shower time should not exceed 10 minutes.
• You can take a bath no earlier than a month after surgery. It is best to additionally ask your doctor about the possibility of this water procedure.
• If a lump appears above the seam, tell your doctor immediately.

While the patient is in the hospital, the treatment of his sutures is carried out by health workers, but by the time of discharge, the patient must learn how to process them independently. In case of inaccessibility of the scar, doctors recommend using the help of relatives or health workers of the clinic.

Any complication is easier to avoid than to treat. To do this, you must follow all the instructions of the surgeon, carefully care for the postoperative wound. As a rule, without complications, the healing of the sutures takes about a month.

Many patients are faced with such a problem as sealing the seam after cesarean. Pathology can develop under the influence of various reasons. To determine if a bump on the seam is dangerous, a woman must be examined at a medical center. Only then can a treatment method be chosen. You also need to understand that the problem is not always pathological. In many cases, the seal does not pose a danger to the life and health of the patient.

A caesarean section is performed by cutting tissue in the abdominal region. The postoperative incision is fastened with medical materials. The muscle tissue is sutured with a ligature. A silk thread is applied to the skin. The uterus is held together with various materials. The choice of material depends on the type of section and the characteristics of the operation. After a caesarean, there is a recovery period. At this time, the sutures should be covered with scar tissue. But the process doesn't always go smoothly. Some patients complain that the seam turned red after a cesarean section. Seal on the abdomen after cesarean may appear for the following reasons:

• development of a purulent process;
• tissue infection;
• use of low-quality material;
• postoperative hematoma;
• autoimmune reaction.

A common cause of seam sealing is a purulent process. Suppuration is observed under the influence of various factors. The process is common due to improper processing of the postoperative field. Damaged tissue is accompanied by the death of some cells. Dead cells accumulate on the surface of the wound. To enhance healing, the incision is covered with leukocyte cells. Mixing of dead tissue, leukocytes and keratinized skin particles leads to the formation of pus. Pus leads to inflammation of the seam. The tissues begin to thicken.

There is a seal on the seam after cesarean due to infection. Many infections depend on the activity of pathogenic microorganisms. Bacteria can get into the wound during poor-quality surgery or after a cesarean with rare treatment. Pathogenic microorganisms multiply rapidly and cause a change in the structure of the tissue. Bacteria feed on tissue cells. The area of ​​tissue affected by pathogenic microbes becomes inflamed. The aggravation of the process is accompanied by compaction. A woman discovers bumps on a wound. Bacterial infection is also determined by additional signs. The patient notices severe burning and itching. An ichor may appear on the surface of the seam. In order for the doctor to quickly select an effective treatment, it is necessary to undergo an additional examination.

Additional factors

The seam after caesarean section can be sealed when using low-quality medical material. The seal appears due to expired threads. Such material causes the formation of a seal. To get rid of the problem, a second surgical intervention should be performed.

In the first days after a caesarean section, a seal is formed due to a hematoma. Hematoma after caesarean section is a common problem. The bruise appears due to internal bleeding. The area of ​​the abdominal region, on which there is a bruise, is hard and dense on palpation. This problem in most patients does not require additional intervention. A few days after the surgical intervention, it resolves.

An autoimmune reaction is rare in women. It is impossible to determine the disease in advance. Pathology is characterized by the rejection of medical material by the human body.

For unknown reasons, the body perceives the threads as a foreign body. This leads to the appearance of antibodies in the blood. These are special particles designed to capture foreign microorganisms. The response of the autoimmune system is unpredictable. This problem can be solved only by selecting another material or prescribing a drug to eliminate the activity of the system.

Formation of postoperative fistula

Ligature fistulas are a common problem after surgery. Pathology gradually appears in the muscular layer of the abdominal cavity. The name of the problem was due to the peculiarities of its appearance. The culprit of the disease is the ligature that has not been completely decomposed. The threads on the muscle layer should completely decompose a few weeks after the caesarean section. But under the influence of various negative reasons, this does not happen. Part of the ligature is preserved in the abdominal region.

The ligature causes inflammation in the damaged tissue. The process is accompanied by the death of the cells of the muscle layer surrounding the thread. Dead cells accumulate on the surface of the ligature. The body responds to pathology by producing a large number of white blood cells. Together with the tissue, leukocytes form pus.

Suppuration causes further death of the layers of the abdominal cavity. The problem cannot be detected immediately. The woman notices that a small bump appears on the surface of the seams.

Compaction is accompanied by the appearance of a small swelling like a boil. Some time after the operation, a purulent head forms on the upper part of the tumor. The skin is torn. Pus begins to be removed from the fistulous canal.

Ligature fistula is accompanied by additional symptoms. A woman should pay attention to the following signs:

• throbbing pain in the suture area;
• redness of the skin;
• feeling of fullness in the area of ​​the scar.

The main sign of developing internal suppuration is throbbing pain in the suture area. Pulsating pain occurs due to the gradual death of tissues. You should also pay attention to the feeling of bursting of scar tissue. It is also provoked by purulent fluid.

The doctor establishes the diagnosis after the initial treatment of the fistulous canal. An antiseptic solution is injected into the lumen. Hydrogen peroxide has a good effect. Peroxide breaks down pus and removes it from the canal. After a thorough cleaning of the fistula, the doctor examines the cavity. The rest of the ligature is found in the muscle layer. You can't leave content in a channel. It will cause further tissue destruction.

Treatment is by surgical intervention. The doctor removes the remnants of the threads from the canal. A new suture is not applied to the wound. After the intervention, the woman remains in hospital. This is necessary to further track the rate of healing. It is also necessary to ensure that a new fistula does not form.

Neoplasm with lymph

Seal over the seam after caesarean section may form due to the formation of a lymphatic cavity. This happens against the background of dissection of the lymphatic channels.

All layers of tissues are fed by the lymphatic system. During a caesarean section, several layers of tissue are cut. Channels are also damaged. After the operation, the tissues are held together with threads. Lymphatic channels and vessel walls remain in a damaged state. In most women, the vessels and canals heal on their own. In some cases, the internal lymphatic canal does not grow together. The liquid that moves through the channel enters the free space. A small cavity filled with lymph is formed in the peritoneum.

Such a neoplasm is called a seroma. To determine its presence, you need to pay attention to the following signs:

• round neoplasm on the skin;
• redness of the skin in the affected area;
• burning sensation.

The main sign of seroma is the formation of a rounded red neoplasm on the skin. In most cases, seroma does not require treatment. She is able to heal on her own. If the seroma persists for a long time, it is necessary to open the surface of the seroma and release excess lymph. The wound is washed with a solution of chlorhexidine or sterile liquid furacilin. Gradually, the damage will heal on its own.

Uncharacteristic scar tissue

The seam after a caesarean section can be sealed for other reasons. The surface of the wound after the operation is covered with a thin film, which forms a scar. Normal scar tissue should not rise above the skin. Immediately after formation, the tissue has a red color. After a while, the seam brightens and becomes less noticeable to others. But sometimes the scar is formed incorrectly. Under the influence of negative factors, the rumen cells begin to multiply actively. A keloid scar forms on the wound. The causes of a keloid scar are as follows:

• transferred infection;
• violation of the update process.

Keloid tissue cannot harm the health of the patient. There is a psychological problem. The scar ruins the look. Doctors recommend treating a keloid scar with cosmetic techniques.

A hard scar can be removed with a laser. The laser beam has a warming effect on the tissue. She melts. A burn forms on the scar. It is not recommended to remove the burn crust on your own. It should fall off completely after a while.

You can resort to grinding. The working surface of the grinder rotates at high speed. Under the influence of friction, the convex part of the scar is gradually eliminated. Several treatments may be needed to achieve a good result.

Preventive measures

To avoid problems, you must follow the advice of a doctor. To get a good result, you need to properly transfer the recovery period. The first days after a caesarean section, you must follow the rules for processing the incision. For several days, the treatment of sutures is carried out by medical personnel. The procedural nurse can teach the patient how to clean the wound on her own. In order for the sutures to heal properly, it is necessary to use an antiseptic solution and a drying drug.

Initially, the suture is washed with an antiseptic liquid. Processing is carried out until the complete removal of contaminants. After removing the crust, the edges of the wound should be lubricated with a drying preparation. For this purpose, you can use brilliant green or fukortsin. Processing should be carried out at least once a day. This will help prevent infection or inflammation.

It is also necessary to seal the surface of the seam with a postoperative bandage. Bandages can be purchased at the pharmacy. Manufacturers offer a wide range of dressings from various materials.

After the formation of thin scar tissue, a woman should carefully monitor her health. The following should be of concern:

• the appearance of redness around the seam;
• the appearance of blood or ichor from the wound;
• changes in the characteristics of vaginal discharge;
• pain in the area of ​​the incision.

Redness of the tissues surrounding the sutures may be due to the development of inflammation or infection of the wound. The appearance of blood and ichor from the wound is dangerous a few weeks after a cesarean section. Such a phenomenon can occur with the initial form of suppuration.

A caesarean section is a complex and traumatic operation for a woman. After surgery, it is recommended to carefully monitor the characteristics of the suture. If a hard scar is found on palpation, it is necessary to visit a doctor. The specialist will determine the cause of the seal and select an effective treatment.

Types Features of the recovery period In the hospital Home care Complications Subsequent pregnancies

A caesarean section is a delivery surgery in which the baby 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 suture after a cesarean section will look (isn't it ugly?), how much will it be noticeable and how long will the healing process take. 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 better a woman is aware, the less problems she will have in the future.

Kinds

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, unequal types of sutures are obtained that require special care.

vertical seam

If acute fetal hypoxia is diagnosed or the woman in labor begins to bleed profusely, a caesarean section is performed, which is called corporal. The result of such an operation is a vertical seam, starting from the navel and ending in the pubic area. It does not differ in beauty and in the future will spoil the appearance of the body quite strongly, since the scars are nodular in nature, very noticeable against the background of the abdomen, prone to thickening in the future. This type of operation is performed quite rarely, only in emergency cases.

Horizontal seam

If the operation is planned, a Pfannenstiel laparotomy is performed. An incision is made transversely, above the pubis. Its advantages are that it is located in a natural skin fold, the abdominal cavity remains unopened. Therefore, a neat, continuous (special overlay technique), intradermal (so that there are no external manifestations) cosmetic suture after a cesarean section on the body is invisible.

Internal seams

The internal sutures on the wall of the uterus in both cases are varied in the way they are applied. The doctor is guided here by the fact that to achieve the best possible conditions for faster wound healing without complications, to reduce blood loss. Here you can not make mistakes, since the course of the next pregnancies depends on this. During a corporal operation, a longitudinal internal suture is made after a caesarean section, with a Pfannenstiel laparotomy - a transverse one:

the uterus is stitched with a continuous single-row suture made of a synthetic, very durable, self-absorbable material; the peritoneum, like muscles, after cesarean is sutured with continuous catgut stitches; aponeurosis (connective tissue of muscles) is sutured with absorbable synthetic threads.

The speed of healing, features of care, various complications - all these important points directly depend on which incision was made during the caesarean section. After childbirth, doctors advise patients on all issues that cause them doubts, anxieties and fears.

About personalities. Hermann Johannes Pfannenstiel (1862-1909) - German gynecologist, first introduced the surgical transverse incision into practice, which received his name.

Features of the recovery period

It will depend on the type of incision made how long the suture heals after a cesarean section in terms of pain and other consequences of the operation. It will take longer to tinker with the longitudinal one, and the risk of complications will be much higher than with the transverse one.

Pain

After childbirth, a wound remains on the uterus, as well as on the anterior wall of the peritoneum, so it is not surprising that after a cesarean section, the seam hurts (even severely) in the first weeks, or even months. This is a natural reaction of tissues to the incision made, so that the pain syndrome can be blocked with the most common painkillers:

immediately after the operation, analgesics (narcotic) are prescribed: morphine and its varieties, tramadol, omnopon; in the subsequent period, analgin supplemented with ketanovy, diphenhydramine and other anti-inflammatory nonsteroidal drugs can be used.

At the same time, do not forget that the painkillers used should be prescribed by a doctor, taking into account the lactation period. As for the question of how long the seam hurts after a cesarean section, it depends on its type. Longitudinal will disturb about 2 months, transverse - 6 weeks with proper care and without complications. However, even during the year, a woman may feel pulling, discomfort in the operated area.

Hardness

Many are concerned about the fact that after a cesarean section, the seam is hard and hurts: within 2 months, this is quite normal. Tissue healing occurs. In this case, the scar does not immediately become soft and invisible. You need to come to terms with the fact that some time must pass, which can be calculated not even in months, but in years.

A vertical (longitudinal) hard scar lasts 1.5 years. Only after this period, the tissues will gradually begin to soften. The horizontal (transverse) cosmetic heals faster, so hardness and thickening over the seam (adhesions, scarring of tissues) should go away within a year. Many people notice that over time a characteristic fold forms over the seam, which, in the absence of pain and suppuration, does not present a problem. This is how scarring of nearby tissues occurs. To avoid unpleasant consequences, it is recommended to do an ultrasound. It is much more serious if, after a cesarean section, a bump appears above the seam. Someone notices it already in the first year, for some it manifests itself much later. Sizes can be completely different: from a small pea to a walnut. Most often it is purple or purple. In this case, a visit to the doctor and ultrasound are required. It can be either harmless scarring of tissues, or fistula, inflammation, suppuration, and even cancer formation.

The hardness of the scar, all kinds of folds and seals around it in the first year after the operation is a fairly common phenomenon. If all this is not accompanied by severe pain and suppuration, you should not worry. But as soon as a bump appears on the seam and the above symptoms, consultation with a specialist and treatment are inevitable.

Allocations

If the suture after a caesarean section oozes ichor (clear liquid) in the first week, no need to worry. This is how healing happens, it's a natural process. But as soon as the discharge becomes purulent or bleeding, begins to emit an unpleasant odor, or flows for too long, you should immediately contact a specialist.

Itching

For everyone who has had a caesarean section, the scar is very itchy after a week, which scares some. In fact, this indicates wound healing and nothing more. This is an indicator that everything is going its own way. However, touching and combing the stomach is strictly prohibited. Now, if the scar does not just itch, but already burns and bakes, causing suffering, you must definitely tell the doctor about it.

In order for the recovery period after cesarean to proceed without undesirable consequences and complications, a woman needs to learn how to properly care for the operated area.

Read more about recovery after caesarean section in our separate article.

through the pages of history. The name of the caesarean section goes back to the Latin language and literally translates as "royal incision" (caesarea sectio).

In the hospital

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

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). All procedures are performed by a nurse. The dressing is changed daily after the caesarean. All of this takes place over the course of about a week. 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 the level of pain threshold. But in most cases, the procedure is comparable to plucking the eyebrows: at least the sensations are very similar. 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.

Do not lift heavy things (anything that exceeds the weight of the newborn). Avoid strenuous exercise. Do not lie down after a cesarean all the time, walk as much and as often as possible. 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. 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. 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. To prevent the divergence of the seam, wear a bandage that fixes the stomach. Avoid mechanical damage after cesarean: so that the scar is not subjected to pressure and rubbing. 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. Eat right for faster tissue repair and faster healing of scars. 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. Several times a day (2-3) for at least half an hour, expose the stomach: air baths are very useful. 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:

elevated temperature; 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 the individual characteristics of the 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 from giving birth again after a cesarean. 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 sensations. 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 differently for everyone and depends on many factors: the process of childbirth, the type of incision, the state of health of the mother, proper care in the 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.

After caesarean section, the main complaints of patients relate to the state of the suture. Complications can arise for various reasons. The most common complication is the seal on the seam, but this complication is not always dangerous and in most cases does not require additional treatment. In order to understand whether the compaction is dangerous or not dangerous, it is necessary to seek the advice of a surgeon. Self-treatment can only aggravate the situation and lead to the need for urgent surgical intervention.

Danger signs

Among the dangerous signs of a developing complication after a caesarean section, one can single out compaction and suppuration of the sutures. This is a fairly common occurrence, which is noticeable to the naked eye when examining the seams. Stitch problems can occur for a variety of reasons, including:

infection of the suture, poor quality of the suture material, insufficient qualification of the surgeon, rejection of the suture material by the woman's body.

Every woman should understand that the suture must be carefully monitored for several more months after the operation, and if such phenomena as seals, soreness, redness or suppuration are found, it is necessary to immediately seek the advice of a surgeon.

Ligature fistula

This complication is the most common after caesarean section. After the operation, the incision is sutured with special threads - ligatures. These threads can be absorbable and non-absorbable. The healing time of the scar depends on the quality of the ligature. If the material was of high quality, used within acceptable expiration dates, in accordance with the norms and rules of treatment, complications are unlikely.

But if the ligature was used after the specified expiration date or an infection got into the wound, an inflammatory process begins to develop around the thread, which can form a fistula a few months after cesarean.

The fistula is very easy to detect. It has such signs as a non-healing wound, from which a certain amount of pus is periodically released. The wound may be covered with a crust, but then it opens again and pus is released again. This phenomenon may be accompanied by fever, chills and general weakness.

If a fistula is found, the help of a surgeon is necessary. Only a doctor will be able to detect and remove the infected thread. Without removing the ligature, the fistula will not go away, but will only increase. Local treatment will not bring positive results. After the thread is removed, additional care is required for the suture, which the surgeon will prescribe for you.

If the infection process has been delayed, or several fistulas have formed on the scar, an operation may be required to remove the scar with repeated suturing.

Seroma

Seroma is also a common complication after caesarean section. But unlike the ligature fistula, this complication can go away on its own, without additional treatment. A seroma is a seal on a seam filled with fluid. It occurs at the intersection of the lymphatic vessels, which cannot be sutured after the incision. At the intersection of the lymphatic vessels, a cavity is formed, which is filled with lymph.

Without additional danger signs, a seroma does not require treatment and resolves on its own within a few weeks.

If a seroma is detected, you should immediately visit a surgeon to determine the exact diagnosis and exclude suppuration.

Keloid scar

Another most common complication after caesarean section is the formation of a keloid scar. Recognizing it is also not difficult.

The seam becomes rough, hard and often protrudes above the surface of the skin.

At the same time, there is no pain, redness around the scar and pus.

A keloid scar does not pose a risk to the health of patients and is only an aesthetic problem. The causes of scarring are considered to be the individual characteristics of the organism.

Today, there are several methods of treating this unsightly phenomenon:

Laser therapy is based on the resurfacing of the scar with a laser. Several sessions of therapy can make the scar less noticeable. Hormone therapy includes the use of special medications and ointments containing hormones. The use of creams will help reduce scar tissue and make the scar less pronounced. Surgical treatment consists in the complete excision of scar tissue, followed by new sutures. This method does not guarantee that a normal scar will form at the site of the removed scar.

In order to avoid all these and other complications in the postoperative period, it is necessary to carefully care for the suture and follow all the recommendations of doctors. If any signs of complications develop, visit a doctor immediately, in which case you can avoid surgical treatment.

An operative method of delivery becomes inevitable when the fetus occupies the wrong place in the uterus or there are complications in the form of placenta previa, cord entanglement. Sometimes there are no direct indications for a cesarean, just a woman, for example, no longer plans to have children and wants to perform surgical sterilization during the operation.

Regardless of the reasons for delivery by surgery, it should be remembered that caesarean is a major abdominal intervention. In the process of childbirth, in order to remove the baby from the uterus, doctors have to make several incisions in layers. After the operation, the woman's abdominal cavity is also sutured in layers, as a result of which a scar will remain on the anterior abdominal wall for life.

Types of stitches after cesarean

Depending on the tissue incision technique, a woman can have different types of sutures:

• vertical - superimposed when the incision is made vertically, from the navel to the pubic area;
• transverse - the incision is made along the bikini line, referred to in medicine as the Joe-Kohen laparotomy;
• in the form of an arc - an incision is made in the area of ​​\u200b\u200bthe skin fold above the pubis (Pfannenstiel laparotomy).

Suture care after cesarean: treatment, ointments, creams

The treatment of the postoperative wound and sutures is carried out several times a day in the maternity hospital, and this procedure is performed by a nurse. To prevent weeping and the development of inflammatory processes in the suture area, the incision site is treated twice a day with a solution of brilliant green, after which it is covered with a sterile gauze bandage.

Approximately on the 7th day, the sutures are removed, however, the puerperal should continue to treat the wound with brilliant green at home until it is completely healed. After complete healing and scar formation, the incision site can be treated with an anti-inflammatory cream, which includes components that accelerate skin regeneration.

When suturing the wound surface with self-absorbable sutures, it is not necessary to remove the sutures, however, to speed up their resorption, the doctor may recommend the use of special ointments and creams. These drugs will serve as a prevention of the formation of seals and swelling in the seam area.

How long does a suture heal after a caesarean?

The formation of a scar at the site of the incision is observed by the end of the first week after delivery. From about this moment, a woman is allowed to take a shower and lather the area of ​​\u200b\u200bthe seam, without making sudden movements and without pressing on the incision site with a bathing sponge.

Complications on the seam after caesarean section

Unfortunately, the incision site does not always heal and does not bother the patient; some young mothers have to face complications.

The seam after cesarean hurts

Pain in the suture area can disturb a woman for several months. After complete healing of the wound surface, the suture may disturb the patient when the weather changes, loads, wear tight clothing. Such sensations are normal and do not require the use of drugs. The following symptoms should prompt immediate medical attention:

• redness of the skin around the seam;
• local increase in body temperature;
• swelling and sharp soreness of the place of suturing;
• discharge from the seam of liquid mixed with blood or pus;
• a sudden increase in body temperature, accompanied by the above symptoms in the suture area.

Seam after cesarean: festering, oozing

In the first few days after the operation, the suture may ooze a clear liquid, but pus or scarlet blood should not stand out! Treatment with a solution of brilliant green will help prevent the development of complications.

In the event of pus or bloody discharge from the suture a few days or weeks after the cesarean section, the woman should seek medical help, perhaps an infection has entered the wound and provoked the development of the inflammatory process.

Seam after cesarean: itchy

Itching in the suture area after operative delivery occurs as a result of the formation of a postoperative scar. This process is accompanied by increased dryness of the skin and tissue tension, which leads to discomfort. In order not to accidentally introduce an infection into the wound, it is not recommended to touch the seams with your hands; the use of special emollient anti-inflammatory creams and ointments will help reduce itching of the skin.

Hematoma, lump on the suture, induration of the suture after caesarean section

As a result of suturing and trauma to the blood vessels in the area of ​​the wound surface, a hematoma may form in a woman. Most often this occurs on the inner surface of the uterus, and pathology can only be diagnosed through ultrasound. If the hematoma is not treated, then over time a seal may form, which prevents the normal nutrition of tissues in this area and is a predisposing factor for the development of inflammatory processes.

After going through an operative delivery, a woman should be prepared for the fact that the suture on the anterior abdominal wall will not immediately become inconspicuous and painless. In the first months and even years, the formation of bumps and various seals in the suture area is permissible, which is associated with the processes of tissue healing. Such seals will completely resolve only 1-2 years after the intervention, which the patient just needs to come to terms with.

Can the seam on the uterus after cesarean disperse?

After a caesarean section, you should be extremely attentive to your health. Heavy lifting, strenuous physical activity, and early intimacy can lead to sutures coming apart. A new pregnancy is also dangerous: due to the insolvency of the scar and as the uterus grows, a strong tension of the tissues is observed, as a result of which the internal seams can disperse at the incision site. A new pregnancy after operative delivery can be planned no earlier than 3 years after cesarean.

Ligature fistula after cesarean

The formation of a ligature fistula occurs as a result of the use of poor quality suture material or the individual intolerance of the woman's body to the used threads. The complication is characterized by an inflammatory process of the skin around the suture, which develops several weeks or months after the operation.

As the pathology progresses, a hole is formed near the suture site, through which pus is released when pressed. The treatment of the hole and the course of antibiotics do not give the desired result, and the treatment of this complication is carried out only surgically, during the intervention the doctor will remove the ligature and the wound will heal soon.

Adhesions after caesarean section

Adhesions are formed after any surgical intervention, their formation is aimed at preventing purulent-septic processes in the small pelvis. With the formation of adhesions in excess, they speak of the development of adhesive disease, which can lead to subsequent ectopic pregnancies, intestinal obstruction, and infertility.

Aesthetic correction of the seam after caesarean section

A scar after a cesarean section, especially if the incision was made vertically, often becomes the reason for the formation of complexes in a woman, so she tries to get rid of it by all means.

How to remove the scar after caesarean?

First of all, in order to make the scar less noticeable, immediately after the healing of the wounds, cosmetic procedures should be started - the cream, which includes mumiyo, must be rubbed into the scar twice a day. According to patient reviews, over time, the scar becomes pale and not so conspicuous.

Suture plasty after caesarean section

If a woman is dissatisfied with the results of caring for the suture area and she is still not satisfied with the appearance of the anterior abdominal wall, she can decide on a radical procedure - plastic surgery. Before you go for such an intervention, soberly assess the possible risks, since like a cesarean section, plastic surgery has its drawbacks.

Is it possible to get a tattoo on a caesarean scar?

Many women decide to correct the appearance of the anterior abdominal wall by tattooing in the seam area. This is not prohibited, but you should wait for the formation of a normal scar and complete healing of the tissues.

Irina Levchenko, obstetrician-gynecologist, specially for the site site

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