After a cesarean section there is a lump under the suture. Suture sealing after cesarean section. Hard under the seam in a child

After caesarean section The main complaints of patients concern the condition of the suture. Complications may arise from various reasons. The most common complication is considered to be a seal at the seam, but this complication is not always dangerous and in most cases does not require additional treatment. In order to understand whether a lump is dangerous or not dangerous, you need to consult 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 cesarean section, one can highlight compaction and suppuration of the sutures. This is a fairly common phenomenon that is noticeable to the naked eye when examining the seams. Problems with seams can arise for various reasons, including:

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

Every woman should understand that the suture must be carefully monitored for several months after surgery, and if phenomena such as induration, pain, redness or suppuration are detected, it is necessary to immediately seek advice from a surgeon.

Ligature fistula

This complication is the most common after cesarean section. After the operation, the incision is sutured using special threads - ligatures. These threads can be absorbable or non-absorbable. The healing time of the scar depends on the quality of the ligature. If the material was of high quality, used within the 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, it begins to develop around the thread. inflammatory process, which can form a fistula a few months after cesarean.

A 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 crust over, but then it opens again and pus is released again. This phenomenon may be accompanied by fever, chills and general weakness.

How long does it take for a scar to heal after a cesarean section?

If a fistula is detected, the help of a surgeon is necessary. Only a doctor can detect and remove an infected thread. Without removing the ligature, the fistula will not go away, but will only increase. Local treatment won't bring positive results. After removing the thread, behind the seam it is necessary additional care, which the surgeon will prescribe for you.

If the infection process is prolonged, or several fistulas have formed on the scar, surgery may be required to remove the scar with repeated stitches.

Seroma

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

Without additional dangerous signs, seroma does not require treatment and goes away on its own within a few weeks.

If a seroma is detected, you should immediately visit a surgeon to determine accurate diagnosis and exclusion of suppuration.

Keloid scar

Another most common complication after cesarean 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.

There is no pain, redness around the scar or pus.

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

Today there are several methods of treating this unsightly phenomenon:

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

How long can the uterus contract after a cesarean section and how can this process be stimulated?

In order to avoid all these and other complications in postoperative period, you must carefully care for the suture and follow all doctor’s recommendations. If any signs of complications appear, visit your doctor immediately, in this case you can avoid surgical treatment.

A caesarean section is a surgical procedure to remove a fetus from a pregnant woman’s body if spontaneous childbirth is impossible or for medical reasons.

The operation can be prescribed urgently when the labor activity or planned - before the start of contractions. Depending on this, the surgeon chooses one of 2 main types of cesarean section, which differ in the type of incision, the characteristics of the suture and the postoperative period.

There are about 10 methods for performing a caesarean section. If we consider these techniques from the standpoint of consequences for the mother and the course of postoperative rehabilitation, There are 2 main methods:

1. In case of emergency section or certain indications, the doctor performs an isthmicocorporal laparotomy with an inferomedian incision - opens the skin, subcutaneous fatty tissue, muscles and tendons abdominals, peritoneum and uterus, making a vertical incision from the navel to the pubic area.

In some cases (corporal laparotomy), the incision may extend above the navel. After removing the fetus and placenta, a multi-level suture is applied - first the walls of the uterus, the peritoneum are sutured, then the tendons and muscle part, subcutaneous tissue and skin. The operation lasts up to 60 minutes, the mother's blood loss is up to 800 ml.

Seam features:

seam length from 10 cm or more;
the suture is interrupted (not cosmetic), over time it turns into a fairly thick and dense scar;
recovery period 2 months;
disturbing phenomena in the suture area (pain, roughness, as well as phenomena requiring qualified intervention) can be observed up to 2 years after surgery;
To restore the aesthetic appeal of the abdominal area, women have to resort to special cosmetic procedures to reduce the seam.

2. During a planned caesarean section, the surgeon performs a Pfannenstiel laparotomy - cuts the skin horizontally in the area of the suprapubic fold (at the level of the bikini line; an incision just above or below this line is used in a similar operation according to Joel-Cohen), spreads the muscles and bladder, makes an incision in the lower part of the uterus and removes the baby.

Then the uterus is sutured, and a continuous intradermal suture is made on the skin. The operation lasts 20-40 minutes, blood loss is about 500 ml.

Peculiarities:

seam length is usually up to 10 cm;
there is no risk of postoperative hernias and abdominal wall muscle defects;
lower risk of postoperative complications;
It is allowed to sit down a few hours after the operation; it is recommended to get up no later than a day later;
recovery period is about 6 weeks;
The scar is cosmetic, small, and resolves within 6-8 months.

Suture care in the maternity hospital

At normal course recovery processes suture treatment ends with discharge from the maternity hospital. If there are any non-dangerous pathologies, the doctor, upon discharge, will tell you about the features of caring for the suture at home.

The stationary course of treatment includes 1-2 daily antiseptic blotting and wiping, and in case of complications, applying ointments and treating the edges of the wound.

Popular preparations used to treat seams in hospital and at home

The range of medications for the care of postoperative sutures is quite extensive, however, in hospital practice and the recommendations of prescribing physicians, there are usually only a few items that are the most optimal in terms of therapeutic effectiveness and economic benefit.

Vishnevsky ointment

Balsamic liniment according to Vishnevsky - effective and inexpensive drug for the treatment of festering, inflamed closed wounds. The ointment not only has a pronounced antiseptic effect, but also increases blood circulation in the area of application, promoting wound healing.

The warming effect, as well as the restriction of oxygen access to tissues, limits the use of the drug on open and inflamed wounds and in the first 4 days after surgery. Do not use the balm if you are intolerant to birch tar, castor oil and xeroform.

Hypotheses have also been expressed about the possible carcinogenic effect of the drug components. But sometimes Vishnevsky ointment is applied to a sutured, fresh wound after surgery for lack of other means. In hospitals, the balm is applied to the seam using a tampon 2-3 times a day in the first week.

Chlorhexidine

Chlorhexidine bigluconate 0.05% is an effective and inexpensive modern antiseptic that has replaced the traditional “green stuff” and its analogues. Chlorhexidine does not cause pain and chemical burns open wound, has a liquid, flowing consistency, therefore it is used to rinse and clean not only the adjacent areas, but also the suture itself.

However, sometimes Chlorhexidine causes irritation to the skin, mucous membranes and open wound tissue. The effect of the drug extends to quite wide range bacterial, viral and fungal agents, as well as protozoa. Chlorhexidine is not addictive.

Bepanten

Bepanten, Panthenol and other ointments based on pantothenic acid (vitamin B5) are not antiseptics, but help to activate tissue regeneration, so they are recommended to be applied to the suture site for its speedy healing.

Bepanten has a low antibacterial effect, so it is not recommended for use in the first week for treating a suture after a caesarean section

There are variants of the drug with the addition of some antiseptic (Dexpanthenol with chlorhexidine, Bepanten Antiseptic and others).

Zelenka

To treat the skin adjacent to the incision, use a 1% solution of brilliant green alcohol. The area around the wound, 3-4 cm wide, is lubricated 2-3 times a day for 2-3 weeks after surgery. If there are small bloody discharges at the time of discharge or if they recur some time after returning home, treatment continues on an outpatient basis.

Other drugs

Sometimes the list of prescriptions contains less common medications for suture care, which show similar and sometimes even greater effectiveness.

Home care

Activities for processing and monitoring the suture continue after discharge from the hospital and include several important points that must be observed despite the mother’s workload with housework and child care.

Security mode

A woman who has undergone a cesarean section should not lift weights over 3 kg, bend over or squat for a month. It is necessary to abstain from sexual activity for at least 2 months.

Lactation

Seam processing

Suture after cesarean section at home is necessary daily
treat with the agents recommended upon discharge until the end of the ichor (usually up to 2 weeks).

Diet

To prevent suture dehiscence and support the immune system responsible for fighting possible infections It is necessary to follow a postoperative diet. Well-established work gastrointestinal tract after surgical obstetrics, it protects the woman’s body from intoxication by fermentation and putrefaction products.

A special diet is designed to reduce the risk of intestinal paresis and intestinal obstruction.

After a 24-hour postoperative fast, patients are allowed light broths and unsweetened yoghurts. After the first passing of gases and for a month, boiled, baked, stewed and steamed dishes from lean meat and vegetables, buckwheat, rolled oats, millet and pearl barley porridge.

A week after the section, raw fruits and vegetables of green and white color are gradually introduced into the diet - sources of vitamins, minerals and fiber. In addition, cereals, wholemeal bread, fruits, vegetables, vegetable oils and prunes regulate intestinal motility well. Dairy products indispensable for restoring intestinal microflora.

For the first 3 months, fast food, smoked meats, canned food, pickled foods, mushrooms, baked goods, chocolate, fried and fatty foods are excluded from the diet; To avoid constipation, it is advisable to abstain from rice and potatoes. Food should be consumed in fractional portions 5-6 times a day and drink plenty of water. In the future, the diet is regulated by the needs of the baby during breastfeeding.

Bandage

After surgical delivery, women are strongly recommended to wear a special postpartum bandage or model for those who have undergone surgery abdominal cavity.

This device protects the seam from diverging and creates optimal conditions for tissue fusion, protecting the incision site during muscle tension, which can be caused by carrying a child in your arms, bending over, and even breastfeeding. By reducing the mobility of fused tissues, the product promotes the formation of a neat scar.

The bandage helps avoid stretch marks (stretch marks on the skin), provides the necessary compression for muscles that have been stretched during pregnancy, and helps return the stomach to a flatter shape. A significant role is played by wearing this product in order to contract the uterus and prevent back pain.

After corporal intervention, the bandage minimizes the risk of:

The optimal models for recovery after a cesarean section are a universal bandage and a belt with rigid fixation. Models in the form of panties or a skirt should have a high waist, have a rigid insert on the stomach, and the fabric of the product should completely cover the seam.

The use of a product of a smaller size, excessive tightening of the body, redness and swelling of the skin due to impaired blood supply are not allowed.

When using a bandage, you must ensure that the fabric of the product does not injure the seam and, if necessary, apply elastic bandages or pads. It should be put on in the morning while lying down and removed only for sleep, water and air exercises. hygiene procedures, which takes approximately 20 minutes every 4 hours.

If there are no complications, you can put on a bandage or support fabric one day after surgery. It is recommended to wear the product from 3 to 6 months after surgery.

Contraindications to wearing the device are inflammatory complications in the suture area (discharge, redness, pain, suppuration, fistulas), skin rashes under the bandage area, swelling and severe pain in a stomach.

Bath procedures and personal hygiene.

A week after surgery (after removing the threads) and until the suture heals, it is recommended to take a non-hot shower daily.

The wound area should not be rubbed with a washcloth or applied mechanical pressure when drying: the scar area is washed with water and mild baby soap or detergent. intimate hygiene, and the moisture is removed by blotting movements with a disposable or clean towel, the seam is treated with an aseptic agent (for example, Chlorhexidine with protection of the peri-suture area with “green paint”).

Baths, steam baths, saunas, pools and swimming in open water are prohibited until the end of the recovery period (about 2 months).

It is necessary to ensure the cleanliness of the external genitalia and hands. It is ideal if a woman has the opportunity to wash herself after each visit to the bathroom, but washing her hands with soap after using the toilet, walking and interacting with animals is mandatory.

Air baths.

The suture after a cesarean section heals faster under the influence of ultraviolet radiation from direct sunlight and fresh air.
Sometimes ultraviolet irradiation of the suture is practiced in hospitals before the mother is discharged and continues on an outpatient basis in physiotherapy rooms. When taking an air bath at home, you should avoid physical stress during the session.

Home activities that speed up the resorption of sutures

You can begin to take steps to prevent the suture from getting rougher 1-2 months after surgery if there are no complications.

Methods:

a solution of vitamin E (alfatocopherol acetate), applied to the scar itself;
gel and ointments Contractubex, Derimatix and their analogues are recommended by manufacturers for use immediately after removal of stitches, but their effect on the health of a child during breastfeeding has not been clarified. Vaseline and moisturizing creams help to reduce the scar to some extent.

Physiotherapy

After the operation, lying on the stomach and breathing exercises belly. 2 months after a cesarean section (when the suture softens and the ligature dissolves), you can contact a specialist in physical therapy to create an individual set of exercises that are designed to speed up the healing of the incision site and strengthen the abdominal muscles.

As a rule, these are exercises with a hoop, a Kegel complex, lightweight exercises for retracting the abdomen and body turns, lifting and rotating the arms and legs. Exercise therapy is designed to accelerate the scarring of the uterine and other internal sutures, so it should not be neglected, but if pain or complications occur, the start date for classes is postponed.

How long does it take to heal when sutures are removed: description by month

The course and duration of healing of sutures after a cesarean section depend on the type of incision used during the operation.

Monthly description of external sutures during normal healing:

Period of time	Peculiarities
First 2 weeks	The suture is not yet closed, there is pain and itching
1-2 months	The seam turns into a scar and does not bother you, but there is redness
3 months	The scar becomes lighter, softens, the width of the horizontal scar is reduced, and the color becomes lighter
1-1.5 years	The scar is finally formed, its lightest color and soft state are established. The compaction and formation of folds stops. If desired, you can begin cosmetic procedures to reduce the scar

When should an ultrasound scan of the suture be done?

Ultrasound examination after surgical sutures may be planned or prescribed based on patient complaints.

Features of the recovery period

The recovery period after a cesarean section is the healing time of the external suture, which is about 2 weeks (one of which is a hospital stay).

Pain and itching

Severe pain is observed in the first week after cesarean section. Normally, pain of varying degrees persists for up to 2 months after surgery, itching for up to 3-4 months. Some disturbing painful phenomena can be observed in the first 12 months, especially with changes in atmospheric pressure and changes in weather.

Inpatient pain management methods include intravenous or intramuscular injections non-narcotic analgesic drugs taking into account the regime breastfeeding, applying cold to the uterine area and breastfeeding for the fastest contraction of the uterus, then warming up.

At the outpatient stage, the doctor informs you about safe medications for pain relief upon discharge; you can also contact the supervising gynecologist or pediatrician. Moderate physical activity also helps relieve pain.

The suture after a cesarean section may be itchy. This phenomenon indicates that regeneration is taking place and does not require intervention. Itching sensations can be relieved with soft stroking movements, but not by friction.

If a burning sensation appears, the pain is accompanied by redness of the scar, swelling and temperature, or deep-seated nagging pain lower abdomen, which are sometimes accompanied vaginal discharge, then it is imperative to seek medical advice.

Serous discharge.

Serous discharge is the discharge of transparent lymph and ichor, which should end 1-2 weeks after the suture is applied. If they continue, intensify, or if blood appears in the discharge, you should consult a doctor.

During the normal course of the recovery period, the following should not be observed:

severe bleeding from the external suture and vagina;
opaque discharge with an odor;
redness and swelling of the suture;
increase in body temperature.

Early complications

Early complications are considered to be various adverse consequences of surgery that occur during the hospital stay. If one of the following phenomena occurs, you should immediately contact medical personnel hospitals.

Bleeding

The cause of external (from the incision area) and internal postoperative bleeding, provided that it is carried out properly medical manipulations There may be disturbances in the functioning of the patient’s blood coagulation mechanisms, as well as concomitant diseases, such as diabetes or obesity.

Bleeding from the external suture can occur due to:

excessive muscle tension;
stretching of the skin on the abdomen;
sloppy medical manipulations when processing and changing the dressing;
incorrect connection blood vessels during the operation.

Uterine bleeding (lochia) mixed with mucus is natural for 2 months after surgery, but its abundance should decrease within a week, and the color normally ceases to be bright red. The discharge should not be clear, watery with an unpleasant odor, or purulent; black discharge with an unpleasant odor is also a cause for concern.

If there is heavy or recurrent bleeding from the incision area or from the vagina, the woman’s recovery period in the hospital is extended, the suture is checked and treated, and she may be prescribed intravenous infusions and iron and vitamin preparations and metroplasty.

Hematoma

Hematoma is a hemorrhage from blood vessels under the skin that were not sufficiently strengthened during surgery. Other causes of hematomas may be early or inaccurate removal of sutures.

Predisposing factors are diseases:

kidney;
of cardio-vascular system;
blood (for example, anemia);
phlebeurysm.

Internal hemorrhage is characterized by a feeling of heaviness in the perineal area. Depending on the location and extent of the hematoma, the doctor decides on conservative or surgical removal complications.

Suppuration

Inflammation and suppuration of the suture occurs when a bacterial infection develops on the dissected tissues when particularly viable strains of the pathogen enter the wound or when there is a malfunction immune system patients.

A wound abscess begins with redness, pain in the suture area, accompanied by an increase in body temperature, chills, loss of strength and the discharge of a cloudy sticky exudate with an unpleasant odor from the wound.

Treatment includes a course of antibiotics and scar treatment antiseptics (Vishnevsky ointment, Levomekol, Syntomycin emulsion and others), in case of serious complications - drainage. To prevent suppuration, from the second day after surgery it is necessary to get up (gradually, without jerking) and follow the prescribed antiseptic treatments.

Seam divergence

The suture after a cesarean section may diverge due to several reasons. Opening of the wound edges occurs due to excessive physical activity women in the first days after childbirth, active sports and weight lifting in the future, as well as due to infectious process in wound tissues.

Sometimes the discrepancy is caused by excessively tight underwear or underwear made from coarse fabrics. Wound dehiscence is sometimes observed after stitches are removed and often in women whose child weighs more than 4 kg.

Late complications

Late complications of suture healing are considered to be events that occur after discharge from the hospital, usually within 12 months after surgery.

Seromas

Seroma is a bubble-shaped cavity at the suture filled with lymph. Seromas occur in the first weeks after the intervention due to the filling of the dead-end parts of the lymphatic vessels compressed as a result of the operation and are not a pathological phenomenon. But to differentiate seroma from fistula, medical consultation is necessary.

Ligature fistula

A ligature fistula is a breakthrough of the site of suppuration of the suture material, when it develops on the surgical threads (ligature). bacterial infection. A fistula can also appear as a result of allergic rejection of the ligature.

First, any area on the suture becomes hot, turns red, thickens and swells, pain appears, then in one or more places the suture opens and pus flows out, the general temperature rises.

The site of the breakthrough is a through passage through which air can circulate noisily (hence the name of the complication). Self-opening of the suture allows some of the rejected material and purulent contents to come out, but indicates a dangerous inflammatory process that requires immediate medical attention.

The initial stage of inflammation is treated conservatively - by aseptic treatment or drainage and with the help of antibiotics. But sometimes the infected ligature must be removed surgically, while the wound is cleared of exudate, a new suture is applied using other materials, and a course of antibiotics is prescribed.

The doctor decides on the scale of the operation and the need to excise the fistula. External wound treatment aseptic means at home is not enough.

If the fistula closes on its own after separation of the infected material, the inflammatory process continues and relapses may occur, intoxication of the body continues, which is dangerous due to the risk of inflammation of the peritoneum and internal organs and other consequences.

Keloid suture

After a corporal cesarean section, keloid (colloid) coarsening of surgical sutures is most often observed as a result of a hereditary predisposition and represents the proliferation of dense connective tissue containing collagen. Scars protrude above the surface of the skin, change color, and can cause pain and discomfort.

Hypertrophic scars do not extend beyond the suture and are usually painless; keloid scars grow more extensively. Tissue changes can occur one month after surgery and persist for many years, although stabilization usually occurs within 24 months after the onset of changes.

Such a scar usually does not cause any particular concern, other than aesthetic, however, if the lump becomes patchy, or bumps or discharge appear, you should definitely consult a doctor. The specialist will refer you for an ultrasound examination and help rule out inflammation, ligature fistula and malignant degeneration of tissue in the scar area.

Hernia

The hernia occurs after excision of the abdominal tendons during corporal laparotomy as a result of overexertion when lifting heavy objects, frequent constipation or slow digestion and can be diagnosed many years after the operation. Small hernias require the use of a bandage, large hernias require surgical reduction.

The suture came apart after a caesarean section: symptoms and actions

The most obvious symptoms are the divergence of the external (skin) suture, which are observed more often in the first month after surgery. More dangerous is the failure of the suture on the uterus, the scarring of which lasts for 2 years.

Signs of divergence of the uterine suture:

nagging pain in the lower abdomen;
increased body temperature;
bloody discharge from the vagina, especially renewed or intensified a week after surgery.

The only one the right decision in this case, you should immediately consult a doctor.

Symptoms of external seam divergence:

The suture should be treated with Chlorhexidine, a sterile bandage should be applied, rest should be ensured and a doctor should be called. If the seam does not diverge much, then re-suturing is usually not required and treatment is limited to local tightening. If suppuration occurs, drainage will be required.

How to get rid of a scar: effective methods

The need to resort to scar correction arises both when a woman wants to improve the cosmetic appearance of the skin scar, and for medical reasons when there is a suspicion of incompetence of the uterine scar (“niche” in the area of the suture on the uterus).

Metroplasty: effectiveness

Metroplasty after cesarean section is the application of a second suture on the uterus when the previous scar has failed. The operation is performed openly (laparotomy) or through laparoscopic openings.

The need for metroplasty usually occurs after:

emergency caesarean section;
inflammatory complications in the area of the uterine suture;
surgical termination of pregnancy up to 2 years after the previous intervention;
pregnancy occurring early after section.

If home methods for dealing with rough external scars, discussed in paragraph “ Home care", you can contact plastic surgery and massage. The methods are applicable for fully formed scars (approximately 12 months after surgery).

Sanding: efficiency

In cosmetology, several methods for polishing skin sutures have been developed:

Massage: effectiveness

The effectiveness of massage is lower compared to grinding, but it can be successful on small seams or moderately soften rough defects. Massage is carried out after complete healing using pressing movements several times a day for 5 minutes.

The surface of the seam and the skin of the fingers are pre-cleaned; to enhance the effect, moisturizing creams or special means, promoting the softening of keratin. At the same time, massage will help to break down excess fat, strengthen the abdominal muscles and tighten the skin.

Other techniques

Less effective conservative methods include cryoprocedures (exposure to liquid nitrogen), hormonal external therapy, ultrasonic resurfacing.

Plastic surgery

Surgical excision is performed on minor scars to remove excess connective tissue.

Tattoo

After the seam has completely healed, you can resort to the services of professional tattoo artists. Sometimes successful color and graphic solutions with the inclusion of a seam in the composition can completely disguise a scar.

In addition, keloid scars are treated with silicone and zinc bandages, compression devices, injections of corticosteroids, 5-fluorouracil, interferon, and electrophoresis. Irradiation of scars, which was practiced some time ago, is no longer performed due to the risk of malignancy.
When to plan a pregnancy after a cesarean section?

After the operation, it is highly recommended to refrain from conceiving another child for at least 2 years, so that the uterus has time to form a full-fledged scar, the tissue around the suture has acquired sufficient thickness and the bearing of a new fetus occurs without complications.

Optimal time for next pregnancy occurs 3-10 years after cesarean section. Provided that a horizontal sparing incision and a synthetic (or semi-synthetic) ligature on the suture were used during the previous operation, a pregnancy following a cesarean section can be safely resolved naturally.

Article format: Vladimir the Great

Useful video about caesarean section

Pros and cons of CS:

Caesarean section is a rather complex delivery operation, which is necessary to remove the baby through the anterior wall of the mother’s abdomen. Naturally, it leaves a seam.

Its size and shape depend on many factors - the complexity of the operation, the skill of the surgeon, competent postpartum care, and the woman’s physique. Often a ridge forms over the scar, which is difficult to hide even under clothing. It causes discomfort to young mothers, so they are interested in how to get rid of this annoying drawback.

What's in the roller and how to get rid of it?

Often women complain about a “roller” after a caesarean section, without completely understanding what it is and what’s in it. There are many reasons for the formation of a fold in the seam area. Therefore, it is very important to determine the cause of the trouble. If the abdomen is too large and protrudes, this may be due to muscle weakness or linea alba diastasis. Occasionally, women after a cesarean section are also bothered by a hernia. But in such situations, the stomach rarely resembles a fold. And the characteristic ridges are usually formed from fat, skin, or due to swelling of the suture after surgery. Depending on the causes of the problem, the ways to solve it will differ.

Hard ridge around the scar

Many women complain that after surgery the suture looks like a hard cushion and does not want to dissolve. This is completely normal. The transverse suture, which is now used everywhere, heals completely within a year. All this time it can remain dense. A small fold is also often formed above the seam. This is how scarring of surrounding tissue occurs.

In most cases, in the absence of severe pain and suppuration, some hardness and the presence of a cushion are not dangerous and go away on their own over time. If a woman is worried, she can undergo an ultrasound.

A dangerous sign is the appearance of a lump above the seam. It can be small, like a pea, or reach the size walnut. This can manifest itself as harmless tissue scarring, as well as inflammation, suppuration, fistula, etc. In this situation, consulting a doctor is mandatory. In other cases, the roller dissolves on its own.

Skin fold over the scar after cesarean section

Try squeezing the bead over the seam with your hand. If it is very thin, then most likely there is just skin there. In this case, it makes sense to wait a little and let the body deal with the problem on its own. Loose skin often stretches on its own, especially at a young age. A light and cold and hot shower. You can also try special cosmetics to increase skin elasticity, although its effectiveness is highly questionable from a medical point of view.

If the roller has not disappeared in a year or a year and a half, it makes sense to contact plastic surgeon. Perhaps during the cesarean section the surgeon made a mistake somewhere or the woman’s skin is not elastic enough.

Fat fold after cesarean section

If, when pinched, the fold turns out to be thick enough and elastic, it is there. You should try to remove it yourself, but it is very important to choose the right methods. Don’t think that only plump ladies have folds of fat. Even with a normal weight, the percentage of body fat can be increased if a woman has little muscle. Therefore, it is very important not just to start eating less, but to create the right diet and start exercising.

With a body fat percentage of 21-24% and normal quantity muscle fat pad disappears in most cases.

To avoid making mistakes and harming yourself, you should consult a doctor before starting training. It is also better to conduct them under the guidance of a professional trainer, at least for the first time. You shouldn’t cut down your diet too much right away, as a woman needs energy to restore her body after pregnancy. The calorie deficit should be minimal.

If you decide to get rid of the bead of fat above the incision after a cesarean section with the help of exercises, follow simple rules:

The first training can begin no earlier than six months after the operation, and intensive abdominal exercises - after a year.
As soon as your health allows, you need to start moving, taking your baby for walks and walking as much as possible.
First exercises for flat stomach- these are household inclinations. Try to wash floors by hand and lean towards your baby more often.
As soon as your health allows, start regularly doing abdominal tucks - this is one of the most effective exercises to strengthen it.
Do not rush to lose weight so that the fat fold does not turn into a skin fold. Give your body the opportunity to slowly adapt to the new weight.

If something doesn’t work out right away, don’t get discouraged and don’t give up. It takes time for the body to recover. Don’t set unrealistic plans for yourself and don’t demand the impossible from your body. You can evaluate the results of working on yourself no earlier than one and a half to two years after the operation.

Caesarean section often has unpleasant consequences. Like any surgical intervention, it can lead to postoperative complications. The most common problem that postpartum women encounter is a seal on the suture after a cesarean section. For example, compaction, redness, purulent formations, and inflammation may occur. All this poses a threat to the life and health of the young mother. Many women worry about an ugly scar that easily spoils even very beautiful figure. In addition to the fact that the scar has an unattractive appearance, it also sometimes causes pain.

There are several reasons for postoperative complications. The most common of them is infection in the scar. In advanced cases, the inflammatory process can result in sepsis. Some complications may go away on their own without medical intervention. How do you know when to see a specialist? What are the causes and types of complications? Details can be found by reading the article further.

Every woman should closely monitor her health. This is especially true for the occurrence of complications after cesarean section. Good looking inseam may begin to fester six months after surgery for no apparent reason.

The most common causes of complications are:

infection;
low quality ligature;
unscrupulous surgeon;
rejection of the ligature by the body.

Infection usually appears shortly after surgery. It can occur during surgical procedures and suturing. If medical equipment is of poor quality or insufficiently sterile, infection can occur during its subsequent processing. Ligature fistula after cesarean section appears as a result of the use of low-quality surgical thread. The process of suturing during such an operation is very difficult process. It is performed in several stages. Performing this work requires real skill from the surgeon. A negligent attitude towards one's own responsibilities can lead to subsequent complications.

Due to individual intolerance, the body itself may begin to reject the ligature. There should be no compaction, redness, or ulcers on the scar. In addition, the scar itself should be flush with the rest of the skin surface and not look inflamed. Any of these symptoms may prompt you to see a doctor. It often happens that surgical intervention is required to eliminate the consequences.

It is important! A poorly executed seam can make itself felt after quite a long time. You should inspect the scar every day while doing your morning or evening toilet. A superficial inspection and palpation for the presence of seals is sufficient.

Timely detection of complications and seeking help from a doctor will help minimize Negative consequences operations.

Complications after cesarean section: examples

Some negative consequences of a cesarean section do not require treatment and go away on their own. To figure out when to visit a specialist, you need to understand what the main complications that arise after this operation are and whether they require treatment.

The most common consequences are:

seroma;
ligature fistula;
keloid scar.

Seroma after a caesarean section it goes away without medical intervention. With this complication, a seal occurs on the seam, in the form of a small ball, inside of which there is lymph. It appears in places where cut vessels intersect. It is not possible to sew them together. This disease does not require treatment. However, if such symptoms are detected, you should visit a doctor to confirm this diagnosis.

Ligature fistula appears only if low-quality ligature was used. An unscrupulous surgeon could use material that has expired, or make a suture with unsterile threads, introducing an infection into it. A fistula is a small suppuration located at the seam. If the lump ruptures, it releases pus. From time to time it may become covered with a short-lived crust. The fistula is accompanied by symptoms of fever: increased body temperature, chills, weakness. The stomach hurts and shoots in the suture area. A surgeon can help treat this formation. Suppuration comes from the thread. In order to stop this, you need to remove the tissue source and eliminate the consequences. After completing all the steps, the doctor prescribes special treatment to eliminate the consequences of a fistula.

Note! If there are several fistulas at the suture, the surgeon may decide to remove part of the skin in the area of the scar as treatment and apply a new suture.

Keloid scar, Unlike other complications, it has one problem - unattractive appearance. With this complication, the incision site becomes significantly denser. The scar turned red and became very hard. The scar begins to visibly protrude above the rest of the skin surface. The suture does not pose a threat to health and therefore does not require treatment. There are several ways to eliminate this scar: laser removal, surgery and hormonal therapy.

In fact, complications after a cesarean section can be much higher. In order to protect your health, you need to carefully monitor your well-being and the condition of the stitch. It is also fundamentally important to follow all medical instructions regarding postoperative rehabilitation. To prevent infection from getting into the scar, be sure to follow the rules of personal hygiene and ensure that only sterile devices and materials are used during dressings. If there are any changes in appearance suture and your sensations, you need to immediately seek help from a surgeon. The doctor will develop adequate treatment tactics.

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

Ligature fistula

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 several months after cesarean.

If a fistula is detected, the help of a surgeon is necessary. Only a doctor can detect and remove an infected thread. Without removing the ligature, the fistula will not go away, but will only increase. Local treatment will not bring positive results. After removing the thread, the suture requires additional care, which will be prescribed to you by the surgeon.

If the infection process is prolonged, or several fistulas have formed on the scar, surgery may be required to remove the scar with repeated stitches.

Seroma

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

Without additional dangerous signs, seroma does not require treatment and goes away on its own within a few weeks.

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

Keloid scar

Another most common complication after cesarean 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.

There is no pain, redness around the scar or pus.

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

Today there are several methods of treating this unsightly phenomenon:

Laser therapy is based on resurfacing the scar using a laser. Several therapy sessions can make the scar less noticeable.
Hormonal therapy includes the use of special medications and ointments containing hormones. Using creams will help reduce scar tissue and make the scar less pronounced.
Surgical treatment consists of complete excision of scar tissue followed by the application of 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 doctor’s recommendations. If any signs of complications appear, visit your doctor immediately, in this case you can avoid surgical treatment.

anonymously

Good afternoon. 2.5 years ago I gave birth to a child by caesarean section (due to high blood pressure), a year ago I noticed a lump on the left above the suture. The lump bothers me, it itches, sometimes there is a sharp pain. At first, especially often, pulling and cutting pains occurred in the first days of menstruation, but now it hurts a lot for several days, then it doesn’t bother me for a week, and so on periodically. First, I was examined by a gynecologist, the examination and ultrasound did not reveal any abnormalities in women, so I was referred to a surgeon. I visited several surgeons, one sent me for surgery, saying they would cut it open and see what it was. The second surgeon re-referred for an ultrasound to a gynecologist and an examination to an oncologist. An ultrasound scan from a gynecologist revealed no abnormalities. On my own initiative, I did an ultrasound of this particular lump, the results are as follows: “In the left iliac region, in the thickness of the muscle tissue, at a depth of 3 to 9 mm, an irregularly shaped hypoechoic formation is visualized, heterogeneous in structure due to cystic and hyperechoic inclusions, measuring 25* 40mm, with fuzzy unevenness! contours (Conclusion: volumetric formation of the anterior abdominal wall).” I'm worried that the pain has begun to intensify, and I feel tired and tense in the lower back. This morning I noticed that the lump began to stick out more and in its place a pale bruise appeared in its place, which was the color of a burgundy, which especially frightened me. I have an appointment with the oncologist only on Tuesday, but I don’t know if I should go to the surgeon again because of the bruise that has appeared? What could it even be?

Hello. You have several options: it could be endometriosis, an intermuscular encysted hematoma, or even a hernial protrusion, and finally some kind of oncological formation. I would advise you to undergo surgical treatment (with further tissue histological examination), during which a correct diagnosis can really be made. And correctly, and most importantly, a timely diagnosis is the key to proper treatment. Good health to you.

Consultation with a surgeon on the topic “bump in the area of the cesarean scar” is given for informational purposes only. Based on the results of the consultation received, please consult a doctor, including to identify possible contraindications.

About the consultant

Details

Surgeon of the highest qualification category. Work experience in planning and emergency surgery 26 years.

He graduated from Kuibyshevsky in 1990 with a degree in general medicine. Internship in surgery at Regional Hospital No. 1 of Ulyanovsk.

He underwent repeated advanced training and advanced training at the bases of Ulyanovsk State University, Penza, N-Novgorod on the topics: “Current issues of emergency surgery of the thoracic and abdominal organs,” also in St. Petersburg on “Endovideosurgery of the abdominal organs and retroperitoneal space.”

Performs various types of planned and emergency surgical interventions, operations for purulent processes.

During my work, I mastered various surgical techniques:

removal of benign tumors of the skin and subcutaneous tissue (atheroma, lipoma, fibroma, etc.) of various locations;
opening of abscesses, phlegmons, felons, necrectomy various localizations, including amputation and disarticulation of both fingers and limbs (upper and lower), e.g. for diabetic or atherosclerotic gangrene;
various types of hernia repairs for inguinal, femoral, umbilical, postoperative hernias, both tension and non-tension types of plastic surgery;
gastric resection according to B-1, B-2 with various types of anastomoses;
cholecystectomy (laparotomy) with various types both external and internal (IDA) drainage of the common bile duct;
little experience in laparoscopic operations, mainly assisting with cholecystectomies and appendectomies;
appendectomy;
suturing of perforated ulcers of the stomach and duodenum;
splenectomy;

I'll tell you about my first birth. When I gave birth to a child and lay in the delivery room with ice on my stomach, nothing hurt... I was filled with a feeling of happiness, despite the presence of tears, both internal and external (by that time already stitched up)... I remember my thoughts then that I could repeat everything again and right now for the sake of my dear little lump. When they put me on a gurney to take me to the ward, I thought: “Yes, I actually can walk on my own. That they’re taking me like I’m some kind of sick person”... The first surprise for me was when the next day I got up to go to the toilet. Before I could reach it, my vision darkened, my head began to spin... I barely managed to grab the wall to avoid falling... This is due to blood loss during childbirth and, as a result, a sharp decrease in hemoglobin. Further, due to the presence of stitches, I could not sit, only lie and stand. And after each toilet, treat the seams with unscented household soap... (I think bactericidal would be suitable here too). As for the toilet... It was absolutely brutal... at least, the next 1.5 months. I even had thoughts about not eating anything at all, so as not to walk... It’s stupid, of course, but when you EVERYTHING HURTS (!!!) below the waist and you’re ready to climb the wall, that’s not what might come to mind... It turns out , physical therapy helps to recover (relieve swelling). If there is one in the maternity hospital, it is very good. I gave birth from Thursday to Friday and on Friday they didn’t touch me at all (except for injections that cause uterine contractions). They did not have physical therapy on the weekend. And I was discharged on Wednesday. So I only received this treatment for three days. And it should be noted that the swelling has become much less. I asked why it occurs, they told me that it was from novocaine. Anesthesia is still given with novocaine. Strange, is it really impossible to think of anything better? (((Regarding intimate life with my husband, I can say that after giving birth I didn’t have it for 4 months. Until the gynecologist scolded me for mocking my husband... I said that everything still hurts, what does it feel like? as if I had one big bruise, she answered: “Well, nothing. You’re a woman. You’ll be patient. Choose some suitable position...”, etc., etc. In general I listened to her advice. Perhaps she was right, you had to start somewhere in order to return to your old life... Yes, of course, all this is forgotten, and I forgot for a while, but now I'm about to give birth for the second time, and again something comes flooding in... So girls, prepare yourself for the fact that you will have to recover, let's say, not easily and quickly. The only consolation is those for whom we endure all this - our children... And Another memory of mine, when I was driving home from the maternity hospital, looked at the women around me, and thought that everyone who gave birth should be given an order. Nothing less. We are all heroines. It’s a pity that men don’t always understand this.

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Horror!!! Girls, why are you writing negative comments here? I agree that everything is individual for everyone, for some it is easier, for others it is more difficult, but after all, people who have never given birth are reading this, and can you imagine what it’s like for them? The girl must be ready for childbirth! not for the worse, but precisely for childbirth, but how she will go through it is another question... and each one will endure everything in her own way. The first time I gave birth to a baby with my buttocks, and not head first, they frightened me, they said that it was so difficult... without painkillers and other things (it was impossible for some reasons), but as it turned out, everything was not as they promised me... and only one person told me reassured me, saying that the pain that we need to try to endure will only be during pushing. That’s how it turned out for me, the contractions weren’t painful, my stomach could have hurt before, so it was the usual pain, and they pushed once or twice and there he was, the baby, it seemed to me that only 5 minutes had passed. So don’t write comments here that recovery takes a long time and it’s terrible, that giving birth is just a complete bummer, etc. Anything can happen, and everyone will endure and experience all these problems and best moments in their own way. I will soon have my second birth, and I knew what to expect, but there was fear, but after reading some of the comments here, I had the feeling that I had never given birth and had no idea what to expect and what to be prepared for, I will Now to drive away from yourself these terrible stupid thoughts and memories of what you read...

Well, it’s okay, I dealt with it!

And the uterus contracted much more painfully than after the first birth. When my son ate (due to which the uterus began to contract), his eyes popped into his forehead from pain. I thought I was about to make a face again. And the contractions were not only painful, but also long-lasting..
And everything else after childbirth is garbage!

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It is very common that after surgery for a violation of the skin, surgeons use sutures. There are a huge variety of sutures; there is even a saying that “as many surgeons exist, there are as many sutures.”

Currently, the development of medicine has made great strides forward, so now the patient has the right to choose the suture thread and even the suturing technique. If a patient complains of pain in the suture area, this does not mean that the surgeon did anything wrong during the operation. However, it is very common to see a lump under the suture after surgery. In this case, you must contact a surgical clinic or doctor.

In most cases, this is due to a complication after surgery, which is called “Seroma”. This is a formation in the cavity that is filled with lymph. In general, seroma usually disappears on its own and does not pose a huge danger to the patient. Its formation is associated with the intersection of lymphatic vessels. And as you know, they, in turn, are much smaller than blood vessels and therefore are not visible to the eye. It is not possible to coagulate or bandage them. The leaking lymph accumulates, creating a cavity.

The only serious complication of seroma is its suppuration. To avoid this, it is necessary to treat the area of the postoperative wound with an antiseptic. In this case, it is best to use a water-based antiseptic rather than an alcohol-based one. It is also necessary to cover the scar with a gauze cloth moistened with a solution of dimexide.

A more serious complication if a seal forms under the suture after surgery is a fistula. In medical practice, a fistula occurs as a result of suppuration of scars after surgery. The immediate cause of this type of complication was implantation contamination and contamination of the suture material by pathogenic microorganisms. In this case, a visible granuloma compaction forms in the area of the fistula.

The formation of a fistula is very easy to recognize on your own, since the symptoms are quite pronounced: compactions or mushroom-shaped granulations appear around the contaminated area of the wound; inflammation of the postoperative scar; discharge of pus from the wound; redness in the suture area; the occurrence of sensations of pain, swelling; increase in temperature (possibly up to 39 degrees).

Of course, after the operation there should be no compactions or formations in the suture area. If this suddenly happens, you must definitely see the surgeon who directly operated on you; if this is not possible, then go to the surgeon at your place of residence. If no measures are taken, such suppuration will lead to the development of an abscess.