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Printed at: 12:15:23 / 27-09-2021

Caring for your wound after having a caesarean section

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This leaflet provides information on how to care for your wound following a caesarean section operation to deliver your baby.

What can I expect after my operation?
A Caesarean section is a major operation. It will take some time for you to return to normal. The outside skin edges of your wound should seal after about two days but the internal healing of muscle and other tissue below the surface goes on for many months.

After your operation you may expect:
• Pain – even quite small movements such as moving in bed, coughing and laughing can be uncomfortable. Simple painkillers can help but if you don’t feel the pain is controlled, speak to your midwife or GP.
• Vaginal discharge and bleeding.
• A surgical wound – in most cases the wound will be 10 – 15 cm long, sitting just below and following your bikini line. It may be closed with either a dissolvable stich or one which will need removing on day 5- depending on the choice of your surgeon.

Am I likely to get a wound infection?
Surveillance undertaken by the Health Protection Agency has shown that approximately one in 10 women having a Caesarean section may develop a wound infection. This is higher than other similar types of surgery and more research is being undertaken to try to understand this better.

However, we know that the following things can increase the risk of wound infection:
• Being overweight
• Smoking
• Diabetes
• A poor diet without enough nutrients It may not be possible to change these factors, especially if your operation was not planned. However, by following the advice below, we can aim to reduce the risk of infection occurring and ensure that any problems are spotted quickly.

What does the hospital do to reduce the risk of infection?
The hospital follows national guidelines on preventing wound infections, including:
• Taking swabs from your for MRSA (meticillin-resistant Staphylococcus aureus). You will be offered treatment to clear this if you are found to be carrying MRSA.
• Using sterile hair clippers rather than a razor to remove any hair at the operation site.
• Giving antibiotics immediately before the operation.
• Ensuring thorough handwashing during your care.
• Keeping a dressing on your wound for the first 48 hours.
• Providing evidence based wound care advice.

What can I do myself to prevent complications?
• If your Caesarean section is planned, have your MRSA swab taken at 34 weeks and at your pre-op appointment.
• Shower or bath on the day of your operation.
• It is not necessary to shave your bikini line before surgery. The tiny cuts that occur from using a razor can increase the risk of infection.

• Look after your wound as described below.
• Do not allow anyone to touch your wound unless they have washed their hands first. Report any problems with your wound promptly to your midwife or GP.

How should I look after my wound?
For the first 48 hours in hospital your wound will be covered by a waterproof, absorbent dressing. This will be changed by the staff if there is any leakage from the wound. We have specialist dressings and wound care products which may be used if needed. Your midwife will advise if a wound care plan is required.

• After 48 hours the midwife will remove the dressing and check your wound.
• The midwife may choose to apply another dressing to provide protection to the wound. This dressing can remain in place for up to three days as long as there is no leakage, or additional pain
and tenderness in the wound.

If the dressing has not already been removed, you should remove the dressing on the fifth day after delivery.

The following are the things you can do to help yourself:
• Always wash your hands before and after touching your wound or dressing.
• Showering is preferable to bathing.
• Do not rub soap, shower gels, or talc directly onto the healing wound.
• Pat the wound dry with a clean towel or a piece of clean kitchen roll kept just for this purpose.
• Wear loose-fitting underwear to prevent rubbing the wound.

What are the signs of infection?
The following signs could mean that you have an infection. You should report these to your midwife or GP as soon as possible:
• You have more pain in the wound or your
womb than you have been experiencing
since delivery
• Your wound is red, swollen or hot
• Your wound has green or yellow weeping or discharge
• Your wound appears to be gaping or open
• You have an unpleasant vaginal discharge
• You are feeling feverish or have a high temperature

What else can I do?
• Do not lift anything heavier than your baby for six weeks
• Do not drive for six weeks
• Rest when possible
• Eat a healthy diet and drink plenty of fluids
• Support your wound during coughing, laughing or sudden movements

Further Support Contacts:
8am-8pm ADAU- 01908 996481
8pm-8am Labour Ward- 01908 996480
Community answerphone: 01908 996484 to leave a non-urgent message.

Further information
National Institute for Health and Clinical Excellence (NICE) (2008) – Preventing and treating surgical site infections. Available at: http://www.nice.org.uk/nicemedia/pdf/CG74SSIUNG.pdf.pdf
Health Protection Agency (2011) Monitoring Wounds for Infections. Available at: http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1203084355902