C-sections are certainly not simple medical procedures! The complex operation involves multiple layers of tissue, the entire abdominal organ cavity, and a whole team of medical professionals. After the baby is born, the surgical team has to suture the uterus and treat the external incision. In fact, there are several layers of incisions that require some form of closure. Each surgery might have different results. Some patients experience c-section complications that lead surgeons to try a non-standard technique. More and more, surgeons are choosing the method or technique that works best for them.
OBs will explain they have a favorite location for their initial incision or a particular process for closing with staples. Their experience has led them to be more comfortable with their chosen method. Perhaps it's an affirmation of more positive outcomes for patient recovery or just more convenient for the surgical team. Regardless, this individualization means no two women necessarily have the same experience with their c-section. Some incisions heal better than others, some patients tolerate pain better than others. The same mother can even have two drastically different recoveries and surgeries from one delivery to the next!
A friend of mine explained how each of her c-sections has been handled differently by the attending physician. In a note of irony, this friend chose to see Dr. Fancy Surgeon because he was...well, a fancy surgeon. He is the leading OB for complex deliveries and surgical intervention in our area. As it turns out, Dr. Fancy Surgeon wasn't around to perform any of her three c-sections! Because she had a different surgeon for each delivery she was able to point on a few key differences. In fact, she has two different c-section scars - a rarity for c-section moms!
Incision placement was a huge factor in another friend's recovery. Her c-section had a scary, painful, and complicated recovery. The incision, which had been closed with staples, remained open and even became infected! After being re-hospitalized to treat the infection, my friend met with the OB who performed the c-section surgery. During the discussion, my friend asked why the surgeon had decided to place the incision in a crease of her skin. The doctor explained it would be more easily hidden; they had gambled with the risk of infection. That gamble just didn't pay off this time.
In future c-section surgeries, doctors placed a wound vac rather than an initial closure. A wound vac is a nickname for "Vacuum-Assisted Closure", also called Negative Pressure Wound Therapy. Yes, it is exactly what it sounds like: a tiny vacuum device that covers your wound. By reducing air pressure on the wound, the wound vac increases healing blood flow to the incision site. A wound vac also:
- Drains excess fluid
- Reduces inflammation
- Inhibits bacterial growth
- Draws wound edges together
The wound vac is meant to be worn 24 hours a day until the doctor removes it. Some OBs prefer to use a wound vac until the incision site closes completely. Others use it for a while, then finish the incision with staples, stitches, or even glue! Most patients get to remove their wound vac within a week of their c-section surgery.
Some OBs are recommending wound vacs as their new standard treatment for c-section incisions. Negative pressure wound therapy shows promise in c-section recovery. If this development can make c-section recovery easier for any mom, I'm all for it!