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Narrator: It's 6:15 a.m., and Lori is being prepped for her scheduled cesarean, or c-section.
Lori: I was instructed not to eat or drink anything after midnight last night.
Nurse: This one is to monitor to see if you're having any contractions.
Narrator: Part of the routine involves taking steps to reduce the risk of infection. While most women do just fine, 6 to 8 percent of c-section incisions end up infected.
Wound care for a c-section begins before surgery. A nurse shaves your belly and gives you a preventive dose of antibiotics through an IV line.
Nurse: This is antibiotic. Since her belly'll be open, it wards off any infection.
Narrator: Once you're in the operating room, your belly is sterilized with Betadine or an antimicrobial antiseptic solution.
Doctor: It's a big procedure. It's an abdominal surgery where we cut through the skin, we cut through the tissues underlying the skin, we cut through the uterus.
Narrator: Dr. Radhi Kakarla is Lori's obstetrician. Lori will receive the most common type of incision, often called the bikini cut.
Doctor: The reason that we use the bikini cut or Pfannenstiel incision is that it is much easier to heal from that incision and the scarring is much less.
Narrator: This type of incision is less obvious and often hidden beneath the bikini line.
A vertical incision requires a longer healing time, and the scar is more noticeable.
Once your baby's been delivered, your doctor will close your wound from the inside out. First she'll stitch your uterus closed, then the layers of tissue and inner skin, and finally, your outer skin.
Doctor: All the sutures that we use are absorbable sutures, so you don't have to have your stitches taken out.
Narrator: For the first 24 hours, your incision will be covered with a sterile bandage to reduce the chance of infection.
Occasionally, incisions are secured with small strips of surgical tape, which fall off on their own, or staples, which are removed within the first week after surgery.
Soon after returning to your room, you'll start receiving anti-inflammatory and pain medication. Some hospitals encourage women to hold an ice pack to their incision during the first day to reduce swelling.
You'll need to stay in bed for 12 to 18 hours before trying to sit up or stand. Once you're able to get up and move, you'll be encouraged to do so. It's normal to feel significant pain around your incision. This may last for several weeks.
Around 24 hours after surgery, your bandage will be removed. From this point on, the best way to promote healing is to expose your incision to the air as much as possible and to keep it dry and clean.
Doctor: When patients leave the hospital, they are responsible for keeping an eye on their incision. And to make sure it doesn't look like an infected cut on your hand, which can be red, hot, and painful.
Narrator: Once Lori's able to get up and move around, she can shower.
Nurse: You can clean your incision with regular soap and water.
Narrator: Be sure to dry the incision after showering and expose the wound to the air.
Don't apply any creams or ointments to the incision until your doctor says it's fully healed, usually about six weeks after surgery.
Doctor: Okay, great. Let me just take a look at your incision. Looks great, no redness, the incision looks like it's healing really really well. Are you up and about, walking around?
Lori: Absolutely, yes.
Narrator: Walking gets the blood circulating and helps the healing process. Lots of sleep is also recommended.
There are some things you shouldn't do for the first two weeks, like driving. Your doctor will outline other activities to avoid in the first four to six weeks of recovery.
Doctor: You're probably going to go home tomorrow, so I just wanted to go over some instructions with you.
No heavy lifting over 15 pounds. No swimming. Take it easy on the stairs, and no sexual intercourse, no tampons, until you see us for your postpartum appointment.
The other things that you need to be very thoughtful of are first, most important, if you have a fever of greater than 101 you need to call us right away.
Any excess bleeding – we define excess bleeding as one to two pads an hour for more than two to three hours. If you see your wound separating, you need to give us a call.
Doctor: When you leave the hospital, your incision should feel soft to the touch. Over the next few days, there will feel like there is some hardness underneath your incision, and that's very normal, it's called the healing ridge.
Narrator: If you follow your doctor's orders, you'll heal faster, though it may not improve the appearance of your scar.
Doctor: How your incision heals depends on a lot of different things – first and foremost, genetics. We all heal and we all scar differently. Other things that can affect how your incision heals are your weight. If your incision has gotten infected or not.
Narrator: One month after surgery, your incision may look a little darker than it did at first, which is a normal part of the healing process. C-section scars tend to fade and shrink over time.
Doctor: You'll know within six months to a year postpartum what your scar is going to look like.
Narrator: Lori's scar appears to be healing well one week after her son Ryan's birth.
Even though things look great on the outside, she still needs to follow her care instructions. Until she sees her doctor again four to six weeks later, she's in the prime recovery time. She needs to lie down as much as possible and take it slow.