My incision story

Warning— this post is a little gross! If you are not interested feel free to skip/move on.

As you may know I've had three c-sections. My first pregnancy I had placenta previa, so I knew early on that I may need to have a scheduled c-section, and it became more and more certain that I was going to as the pregnancy went on.

My second and third, I tried for VBACs, but it didn't work out. Neither one ended in a true emergency c-section but they weren't planned like the first. I don't think this is necessarily relevant to what happened after, just thought I would mention it.

My first two recoveries had zero complications and I even remember anytime I was checked I heard

"your incision looks great!"

The third was a different story.

While in the hospital postpartum I had some drainage from the area. Multiple midwives and finally an OB came and checked on me, but none wanted to do any intervention.

I went home on Tuesday and was feeling good with no issues for a few days, then Saturday came and that night I felt some drainage. We went right to Labor and Delivery Triage. They opened it up a little and decided the treatment would be to pack it.

I went home on Tuesday and was feeling good with no issues for a few days, then Saturday came and that night I felt some drainage. We went right to Labor and Delivery Triage. They opened it up a little and decided the treatment would be to pack it.

The open area was only a 2cm or so portion of the incision. Small, but stubborn. As this time it seemed to be something that would resolve within a few days to a week. Ha.

At first I was going to the doctor every few days, but then I was able to get my husband to learn how to change the dressing and I went down to *only* having to go once a week.

My husband was such a good sport, he changed that dressing and repacked me every day for about six weeks. Unfortunately the wound didn't change much at all during that time. Eventually the doctor I was working with decided we needed to change it up. I was referred to general surgery, but they rejected me! I never got a clear story but it was because they didn't do the surgery themselves and/ or they were too busy. Thankfully my doctor made a bunch of calls and such and got me set up with a home visiting nurse program to start on a wound vac.

A wound vac uses negative pressure to encourage new cell growth and the wound to close from the inside up.

I finally got the wound vac from the medical equipment company and the visiting nurse came to set it up. It is a similar process where there is this sponge material stuffed into the wound, and then it's connected to a tube which goes to the pump. It's kind of like a breast pump. In fact the one I had was made by Medela!

The pump is continuously pulling air and drainage through the tube into the collection canister at the pump. the pump and tube stay connected to you 24/7. You can disconnect the pump (but not where the tube is connected to the wound) to shower but that's about it.

Finally after 4 weeks on the wound vac I graduated.

At that time my wound nurse said the wound was the size of a pencil eraser. It was only one more week with a special dressing before it was completely closed. That was right around almost 11 weeks after she was born. So long!

Research:

A UK study found that 14% of c-sections had wound healing complications. 84% of those complications happened after discharge(!) Not surprisingly, the research says that better postpartum care is needed and wound complications are one way this need is highlighted.

Another study found that preeclampsia and premature rupture of membrane are risk factors for wound complications.

Sources:

Lusher J, Djatmika C. Living with a non-healing caesarean section wound: A mini-review. Int Wound J. 2020 Aug;17(4):1094-1096. doi: 10.1111/ iwj.13373. Epub 2020 Apr 15. PMID: 32293102;

PMCID: PMC7948895.

Carbonnel M, Brot D, Benedetti C, Kennel T,

Murtada R, Revaux A, Ayoubi JM. Risks factors FOR wound complications after cesarean section. J Gynecol Obstet Hum Reprod. 2021 Sep;50(7):101987. doi: 10.1016/j.jogoh.2020.101987. Epub 2020 Nov 16. PMID: 33212324.