The main goals of caesarean scar therapy are to increase the blood supply to the tissues, to improve the elasticity and mobility of the scar, to prevent tissue adhesions and, consequently, to reduce pain.
There are three phases in caesarean section scar therapy:
- phase I – up to 7 days after the operation,
- phase II – from day 7 to 6-8 weeks after the operation,
- phase III – from 6-8 weeks to 1.5-2 years after the operation.
In this blog we will look at therapy in the first two phases.
Phase I (up to 7 days after the operation)
No direct scar work is done during this phase, as the surgical wound is not healed and the scar is not formed. This stage is crucial in the formation of postoperative adhesions. Therapy includes preparing the surrounding tissues and removing the swelling that is accumulated around the wound.
In phase I, we can perform lymphatic drainage of the area adjacent to the scar, i.e. drainage of the abdomen and lower limbs. The drainage will speed up healing and reduce swelling and the risk of complications. The duration of such drainage is approximately 30-45 minutes. Lymphatic drainage of the abdomen is performed using gentle grips at a slow pace. It is also important to teach the patient how to perform the self-drainage.
Phase II (from day 7 to 6-8 weeks after the operation)
At this stage, lymphatic drainage of the abdomen and lower limbs is continued, and gentle drainage of the scar area and the scar itself is introduced.
Techniques of myofascial relaxation of the abdomen are introduced, which cover the immediate scar area and the scar itself.
Kinesiotaping, which is the application of elastic patches to the abdominal skin (including directly on the scar), may also be used. Lymphatic application can be applied to facilitate lymph drainage and fascial application to lift the skin and subcutaneous tissue away from the fascia, helping to reduce swelling and improve blood circulation. The glued fascia application brings the edges of the scar closer together by gently tightening the tape.
It is also important to teach the patient appropriate movements and therapeutic tricks, which she is to repeat at home twice a day.
Antonina Kaczorowska
References:
- Bagrowski Bartosz. Znaczenie fizjoterapii w leczeniu blizn. Rehabilitacja w praktyce 2021; 3: 48-51
- Chochowska M. Praca z blizną po operacji cesarskiego cięcia. Rehabilitacja w praktyce 2018; 5: 36-42.
- Drozd A, Nowacka-Kłos M, Szamotulska J, Hansdorfer-Korzon R. Możliwości zastosowania terapii manualnej w obszarze blizny. Rehabilitacja w praktyce 2021; 4: 34-42.
- Marciniak Małgorzata. Mobilizacja blizny po cięciu cesarskim. Praktyczna fizjoterapia i rehabilitacja. l2021; 131 : 8-16.
