Caesarean section wound care

What can I expect after my operation?

A caesarean section is a major operation. It will take some time for you to return to feeling normal. The outside skin edges of your wound should seal after about 2 days but the internal healing of muscle and other tissue below the surface will go on for many months.

After your operation you can expect:

• Pain – even quite small movements such as moving in bed, coughing and laughing can be uncomfortable. Simple pain relief medication, such as paracetamol which you can buy at your local pharmacy or supermarket can help. If this does not help control your pain, please speak to your midwife or GP.
• Vaginal discharge and bleeding - this will be at its heaviest initially (like a heavy period), gradually decreasing in flow and changing from bright red to brown or yellow white over several weeks.
• A surgical wound – in most cases the wound will be 10 to 15 cm long, sitting just below and following your bikini line.

How will my wound be cared for in hospital?

During your stay in hospital, the nurse or midwife looking after you will check your wound or wound dressing every day. If you are concerned about your wound, please let the nurse or midwife know.

Do I need to have my stitches removed?

Stitches are usually dissolvable. Dissolvable stitches can take up to 6 weeks to dissolve completely. Your surgeon and discharging team will let you know if a non-dissolvable suture (stitch) has been used. They will also inform your community midwife when these need to be removed.

However, if after the dressing is removed you notice any blue suture material, multiple individual suture knots or small plastic beads at both ends of the wound, please let your community midwife know as this could be a non-dissolvable suture that requires removal.

Will I have a dressing?

Different types of dressings may be applied to the wound after the operation. Your surgeon will have decided which dressing to use depending on your individual circumstances.

Some dressings are removed before you are discharged home but many dressings are designed to stay in place for 5 to 7 days. This will be explained to you before you leave the hospital.

Opsite® dressings

These dressings will be taken off before you leave hospital.

Leukomed® and PICO® dressings

These dressings are designed to stay in place for up to 7 days after surgery. The dressing will be taken off by the community midwife visiting you at home.

These dressings can be worn in the shower as they are shower proof. Use a light indirect spray over the dressing (‘light showering’). Do not submerge your dressing under water.

Additional information for PICO® dressings

You will be provided with a patient information booklet about how the dressing works and how to manage while it is in place. ‘Light showering’ is possible when the pump is disconnected (do not spray water directly onto the dressing).

Will I have a scar?

All surgery carries a chance of scarring and it is likely that you will have a thin scar. At first the scar may appear pink or darker in colour but should fade in a few months. Some people may find their scar becomes raised and red. This is called a keloid scar and is more common in people with black or brown skin. If you have any concerns about your scar, this can be discussed with your GP.

How do I care for my wound at home?

Follow the simple steps below to keep your wound clean and dry:

• Shower as soon as you feel able. As mentioned previously, if the dressing is still in place do not spray water directly onto the dressing.
• Try to avoid touching your wound. If you do, always wash your hands thoroughly with soap and water beforehand.
• Do not put soap or any other products on your wound, just use water.
• If your tummy is covering your wound then take care to keep the area clean and dry. If you are able to, try to lift your tummy up at various points throughout the day to allow air to get to the dressing while this is in place and the wound once the dressing has been removed.
• After washing, pat the wound dry gently with a clean towel. Avoid rubbing the wound.
• Try to wear loose fitting, high-waisted clothing and cotton underwear to prevent rubbing of the wound.

When can I return to normal activities?

You should avoid swimming or strenuous exercise until your wound is completely healed, which is about 6 weeks.

You should wait at least 6 weeks before resuming sexual intercourse after a C. Section to make sure your wound has healed. If you have any concerns, it is important to contact your health visitor or GP.

Doctors usually suggest that you do not drive for about 6 weeks. This is to allow the wound to fully heal.

Am I likely to get a wound infection?

Most surgical wounds heal quickly without any complications. A small number of surgical wounds can develop an infection. This happens when bugs or germs enter the cut that was made by the surgeon.

A surgical wound infection can develop at any time from 2 to 3 days after surgery until the wound has healed, usually 2 to 3 weeks after the operation. Although wound infection can happen after any surgery, it is uncommon.

Most wound infections are limited to the skin but they can sometimes spread to the deeper tissues.

Some people have a higher chance of wound infections, such as those with diabetes, those who smoke or those with a raised BMI.

What are the symptoms of infection that I should look for?

Infection can also develop once you are home. You should expect some redness and swelling after surgery but you might have an infection if you develop one or more of the following symptoms:

• The skin around your wound gets red or sore.
• The skin around your wound feels hot and swollen.
• Your wound has a fluid discharge, often green or yellow coloured pus.
• Your wound opens up.
• You feel generally unwell or feverish, or you have a temperature (fever).
• Your wound has a distinctive odour (smell).
• You have more pain in the wound than you have been experiencing since delivery.
• You have an unpleasant vaginal discharge.

What should I do if I develop any of these symptoms?

If you think you have a problem with your wound after you get home, contact your GP, community midwife or Maternity Triage as soon as possible. You may be referred back to Maternity Triage for them to check your wound.

If you feel unwell, contact Maternity Triage. The contact details are at the end of this page.

If the nurse, midwife or doctor thinks that you have a surgical wound infection, they might take a sample from the surface of your wound with a swab and send it to the laboratory for testing. You may be prescribed antibiotics to treat the infection.

Keep yourself well hydrated by drinking plenty of fluids (not alcohol) and take pain relief medication as required.

To help with healing

Remember to rest when you can and take help offered from your partner and others in your support network.

• Keep yourself well hydrated and eat a healthy diet.
• Take pain relief medication as required.
• Do not lift anything heavier than your baby for 6 weeks.
• Do not drive for 6 weeks.
• Rest when possible.
• Support your wound during coughing, laughing or sudden movements.

Contact information

If you have a problem with your wound after you have left hospital, please contact your GP, community midwife or Maternity Triage.

If you feel unwell, contact:

Maternity Triage

Tel: 0300 422 5541 (available 24 hours)

Further information

NHS UK

Information about what happens, recovery and risks of caesarean section

Website: www.nhs.uk/conditions/caesarean-section/

PICO

Information from Smith+Nephew, includes what to do if the device alarms. To view ‘PICO for mums’, please visit:

Website: www.possiblewithpico.com/pico-for-moms

You can view the PICO Patient Guide at:

Website: https://www.possiblewithpico.com/sites/default/files/picoImages/documents/resources/PCPE31-28163-0321%20PICO%207%20Patient%20Guide%20_FINAL%20APPROVED.pdf