According to OECD Health Statistics latest data, in 2018 33.1% of births in Ireland ended in caesarean section.
A caesarean scar mobilization is often overlooked by women. Meanwhile, a scar is not only a visible mark on the outside. During this form of delivery, the skin, subcutaneous tissue, fascia and uterus are cut to a length of 10-15 cm. So you can imagine that there is more to it than just an aesthetics.
The most common issues resulting from disrupted scar remodelling or neglected scar care are:
- pain and pulling sensation around the incision,
- increased pelvic floor muscles tone (tightness)
- adhesions
- discomfort during physical activity
Scar healing
As a result of the natural wound healing process, the skin previously damaged during the caesarean section is replaced by connective tissue. During healing, both anabolic processes (breakdown of excessive collagen) and catabolic processes (formation o collagen fibres) take place.
This process can take up to 2 years after surgery, and the rate of tissue healing is different for everybody. It depends on many factors, including individual predisposition, how the scar is handling and the lifestyle of the woman, including both diet and the amount and type of physical activity.
There are 3 stages of scar formation:
- Inflammatory phase lasting from 2 to 7 days after surgery.
- The phase of hyperplasia and angiogenesis (the process of formation of blood vessels from already existing ones) lasts up to 6 – 8 weeks after surgery.
- The remodelling (rebuild) phase can last from 6 months to up to 2 years after surgery
It is important to respect tissue healing phases when trying to work with the scar. After a week of correct wound healing, the strength at the site of scar formation is 3% healthy skin, after 3 weeks 20%, and after 3 months after incision 80%. This is the maximum strength a scar can achieve.
In the first phase of healing the scar should not be mobilised manually. Starting scar mobilisation techniques during this time can result in the wound spilling out and delayed healing. This is the time when a woman should take it easy. During this time, the most important thing is to rest, be careful when getting out of bed or chair, take care of the dressing and airing the wound (it is good that it is dry, and if it gets wet during the bath it should be changed to a new one)and wearing underwear that does not irritate the incision area. It is also worth mentioning that during coughing or sneezing, a woman can protect the scar by bring the edges of the wound closer together
The second phase of scar formation is the most important from the physiotherapy point of view. It is recommended to start working with a physiotherapist 6 weeks after caesarean section – that is, when the wound on the skin is completely healed. After the examination, the physiotherapist will be able to instruct the patient on how to work with the scar on their own. In a situation where it is not possible to consult a physiotherapist, it is necessary to abstain from autotherapy until full strength through the scar, that is, up to 12 weeks after surgery.
It is normal to feel stinging, pulling, itching or gentle discomfort during scar mobilisation, but is should not exacerbate during or after it.
During the third phase of scar formation, you can still start or continue working with the scar if required. At this stage, you can use more pressure during mobilization, due to the fact that the scar has already reached full strength .
What are the benefits of scar massage?
Scar mobilisation helps to make the scar more elastic and restore mobility to the surrounding tissues. In addition, studies show that stretching scars can prevent excessive scarring, promotes better healing and helps scars become less noticeable.
Taking these special steps to care for your scar can substantially help your scar to look and feel better. You can watch my video with instructions on how to do it in the link below: https://www.instagram.com/p/CcILDQ7AxMF/
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