MIDWIVES should give new mums advice on how to properly care for their C section scars, experts have concluded
It comes as new research reveals the devastating drop in self-confidence suffered by 40 per cent of mothers who undergo the increasingly common procedure. A new guide issued to midwives has said women giving birth by Caesarean section should be advised on the benefits of silicone gels to reduce scarring. Its recommendations were based on evidence from the past 35 years, which indicates a treatment plan can play an important role in minimising marks left behind following surgery.
It found there is currently little official guidance on scar care for the growing number of women undergoing the procedure in the UK, and suggests midwives could help to address the issue. Despite this the guide, published in the British Journal of Midwifery, said midwives were better aware of the need for good general wound care to prevent post-operation infection.
C sections are on the rise in the UK and now account for more than a quarter of UK births.
Figures from NHS Digital show there were 636,401 births in England in 2016-17, of which 27.8 per cent were by Caesarean – up from 23.5 per cent in 2005-06. The guide’s author, George F Winter, a Fellow of the Institute of Biomedical Science, set out to review the guidelines and recommendations available for health professionals. His study included an evaluation of the biology behind how scars form, and made recommendations on the care of those left by Caesarean section. He identified a series of studies dating to 1983 which had found silicone-based treatments – including gel sheets and gels – improved recovery. He said: “Caesarean section is an increasingly common procedure, yet despite evidence of the psychological impact of scarring, there is little guidance to address the care of caesarean section scars specifically.
“The phases involved in normal scarring are well-defined, and products are available to help minimise and treat scarring, with evidence supporting the efficacy of silicone-based products as one element in addressing this challenge. Surgical site infection is one of the complications of caesarean section, and midwives are increasingly aware of the need for greater proficiency in caesarean section-related wound care and education.”
His guide’s recommendations were welcomed by Fagron UK, the manufacturer of Nourisil MD, a new silicone gel that treats scars from wounds, burns, cosmetic surgery, general medical procedures, and C-sections.
Peter Batty, Fagron UK’s general manager, said: “There has been significant evidence over many years which shows that silicone-based gels can be a very effective treatment for scarring.
“It is good to see that midwives are now being made better aware of how silicone gels can form an important part of the pre and post-operative care of women thinking of or undertaking a Caesarean section. Many women who have undergone the operation feel less confident in their body afterwards, so it is important they are informed of the most effective treatments.”
Research conducted by the brand showed 60 per cent of mums aged 18 to 34 refused to wear a bikini after the operation, while almost a third of the over 55s said the same.
One in five women confessed to being too self-conscious to get undressed in front of their partner or to wear tight clothes. Around a third suffered upset or concern due to their scar’s appearance – a figure virtually as high in women aged 55-plus as with 35 to 44-year-olds. Current advice from NICE, the body which provides guidance and advice to the government around health, centres on antibiotics to prevent infection, and wound care. It recommends the dressing is removed 24-hours after the Caesarean, fever is monitored, signs of infection are assessed, and that women should wear loose, comfortable clothes.
In 2009 doctors successfully used silicone gel to treat 30 patients with superficial, hypertrophic and keloid scars – the two main scar types. They suggested silicone gel may help by increasing hydration, resulting in a softer and flatter scar, protecting the scar from bacteria, and reducing itching and discomfort. Nourisil MD, which is available on prescription from February, contains a unique blend of five silicones that combine to maintain the skin’s moisture balance, while improving scar appearance. Its ultra-light, self-drying properties help to flatten, soften and smooth scars, relieving itching and skin discomfort. It works on all skin types by forming an invisible layer that hydrates and protects scars on all areas of the body, including the face.