Wound healing after an abdominal birth
In this article, we would like to introduce you to the wound healing phases and treatment options for a scar after an abdominal birth.
In the healing of this tissue injury, a distinction is made between four phases that contribute to wound healing: the hemostasis, inflammation, proliferation and remodeling phases. We explain each one below.
An abdominal delivery, also known as a caesarean section or caesarean section, is a surgical method of delivering a baby. The baby is delivered through an incision in the mother’s abdominal wall instead of through the vaginal birth canal. There are many reasons for this type of delivery, which we will not go into in detail in this article.
Anneke gave birth to her first child in this way in June 2024 and can now also give you treatment recommendations from her personal perspective.
During surgery, the incision in the lower abdomen results in a scar that requires treatment after delivery. This aims to promote healing , relieve pain , avoid complications and improve the cosmetic appearance . So it’s also important for you as a mom to look after yourself so that you can take care of your little miracle. We explain below what measures can help you.
Immediately after the operation, your scar will be covered with a large plaster for the time being. There are stitches in the inner and outer area, which nowadays usually dissolve on their own and should otherwise be removed approx. 10 days after the operation. You can remove the cover (also with the help of the midwife) at the latest when the stitches are removed. There are various smaller plasters that you can use afterwards. You can use waterproof plasters for showering , but this is not absolutely necessary. You should avoid bathing for the time being, as well as bathing in public waters (the latter anyway due to the lochia, the wound secretion of the uterus, which manifests itself as vaginal bleeding for a few weeks).
Wound healing phases
Haemostasis (a few hours):
The incision causes bleeding. Blood vessels contract in order to minimize and stop the bleeding. Various cells and proteins are involved in this process.
Inflammatory phase (a few days):
Once the bleeding has stopped, the blood vessels dilate again and the immune defense is activated by the metabolism. The affected area may swell and redden. Bacteria are flushed out of the tissue by the body’s own cells.
Proliferation phase (a few weeks):
New blood vessels and tissue (collagen) are formed and scar tissue develops. During this time, it is important to find the right balance between relief and stress so that the injured area regains its functionality without becoming inflamed or sticky again.
Remodeling phase (up to two years):
The final phase is the longest. It can take up to two years until the new tissue is fully formed and consolidated.
Scar care
If there are signs of infection, such as prolonged redness, swelling or pus formation, the scar should be examined by a specialist. Regular follow-up examinations by your midwife or physiotherapist can ensure that the healing process is monitored.
Cleanliness:
Keep the scar clean, sterile and dry for the first few weeks to avoid infection.
Gentle cleaning:
Only use water to gently cleanse the scar. It is usually sufficient to simply run the water over the scar while showering.
Drying:
After showering, carefully dab the scar with a clean towel or allow it to air dry properly.
Cooling:
A cooling pad can relieve swelling and pain. Never use one straight from the freezer, as this can have a negative effect on wound healing as the vessels contract due to the intense cold!
Scar creams or gels:
Products such as creams or gels can improve the appearance of the scar. You can gently massage the tissue after the stitches have been removed. We recommend the products from Decalys – scar-free skin regeneration.
Plaster:
There are silicone plasters that you can stick to the scar after giving birth. You can also use the products from Decalys – scar-free skin regeneration.
Sun protection:
Protect the scar from sunlight, especially for the first two years, as UV rays can darken the scar tissue. Use sunscreen with a high sun protection factor, even if the scar is covered in the sun.
Treatment
Physiotherapy:
In all cases, physiotherapy may be recommended to improve mobility and prevent and release scar adhesions. At Physio Restart, we use kinesiotape and cupping glasses as well as manual techniques and exercises for stretching and stabilization.
Kinesiotape:
You can use a tape application after the stitches have been removed. The tape has a decongestant effect and can reduce the firmness of the scar tissue. We physiotherapists can also help here.
Laser:
Your postpartum midwife can offer you treatment with the CO2 laser quite early on. Small pulses of energy can promote the stimulation of new collagen.
Massage:
After the stitches have been removed and the scar has healed externally (4 weeks at the earliest), a more intensive massage of the scar can help to promote blood circulation and make the scar tissue (collagen) more supple. You should massage in different directions and also pluck the scar with your fingers. Include the tissue above and below the scar. Massaging the entire abdominal wall helps to restore the internal organs and the entire fascia.
Important: We recommend that you always take breaks with the plaster and tape so that the scar can be treated with the other measures and also gets air. For example, you can use the plaster for 3 days, leave the scar free for 1-2 days, massage it and then use the tape for 3 days.
Do you have any questions or need support? Get in touch with us.
Author:
Anneke Penny
References:
Wallace HA, Basehore BM, Zito PM. Wound Healing Phases. [Updated 2023 Jun 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470443/
