WOUND DRESSING (CESAREAN

SECTION)

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 WOUND DRESSING (CESAREAN SECTION)

What is Wound Dressing?

Wound dressings have been used to clean, cover, and protect the wound from the external environment.
By using an aseptic technique and medication, a sterile protective covering is put on a wound/incision.
It is anything that is used in direct contact with a wound to help it heal and prevent further issues or
complications.

Purpose:

Wound Dressing is an essential element of standard wound care. main purpose of wound dressing is to
provide a temporary protective physical barrier, and absorb wound drainage

To sum it up:

Wound dressing provides the most optimum conditions for wound healing while protecting the wound
from infection of microorganisms and further trauma.

What is Cesarean Section?

Also known as a C-section or cesarean birth, is a surgical birthing method that is performed by creating
incisions in an expecting mother's uterus and abdominal wall.

Or in other words it is the surgical delivery of a baby through a cut (incision) made in the mother's
abdomen and uterus. Healthcare providers use it when they believe it's safer for the mother, the baby,
or both. A C-section might be planned ahead of time if you develop pregnancy complications or you've
had a previous C-section

The incision made in the skin may be:

• Bikini cut or across from side-to-side (horizontal). This incision extends across the pubic
hairline.
It's used most often, because it heals well and there is less bleeding. Common incision. Can be
hidden.

Or

• Up-and-down (vertical). This incision extends from the belly button to the pubic hairline.
Requires a longer healing time, scar is more noticeable.

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The type of incision used depends on the health of the mother and the fetus. The incision in the uterus
may also be either vertical or horizontal.

Cesarean deliveries are generally avoided before 39 weeks of pregnancy so the child has proper
time to develop in the womb. Sometimes, however, complications arise and a cesarean delivery must
be performed prior to 39 weeks.

Why a cesarean delivery is done?

A cesarean delivery is typically performed when complications from pregnancy make traditional
vaginal birth difficult, or put the mother or child at risk.

Reasons for a cesarean delivery include:

• Abnormal fetal heart rate

The fetal heart rate during labor is a good sign of how well the fetus is doing. Your
provider will monitor the fetal heart rate during labor. The normal rate varies between 120 to
160 beats per minute. If the fetal heart rate shows there may be a problem, your provider will
take immediate action. This may be giving the mother oxygen, increasing fluids, and changing
the mother's position. If the heart rate doesn’t improve, he or she may do a Cesarean delivery.

• Baby’s head is too big for the birth canal

Size of the fetus. The baby is too large for the provider to deliver vaginally.

• Baby is coming out feet first (breech birth)

Abnormal position of the fetus during birth. The normal position for the fetus during
birth is head-down, facing the mother's back. Sometimes a fetus is not in the right position. This
makes delivery more difficult through the birth canal.

• Mother’s health problems, such as high blood pressure or unstable heart disease.

• Problems with labor. Labor that fails to progress or doesn't progress the way it should.

• Previous C-section
After a C-section, a woman may not be able to have a vaginal birth in a future
pregnancy. It will depend on the type of uterine incision used. Vertical scars of the uterus are
not strong enough to hold together during labor contractions, so a repeat C-section is necessary

Procedure and Rationale:

PROCEDURE RATIONALE

1. Seek assistance for changing dressing on The person might move and contaminate the
a restless or confused adult. sterile field or the wound.

2. Make a cuff on the moisture proof bag for Having a waste container means the soiled
disposal of the soiled dressing and place dressing can be discarded easily, without the
the bag within reach. It can be tapped to spread of microorganisms.
the bedclothes or bedside table.
Organization facilitates accurate skill
3. Assemble all of the materials needed. performance

4. Greet the client. To provide respect and courtesy to the client.

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5. Explain procedure, purpose and how Explanation encourages cooperation and reduces
he/she can cooperate. anxiety.

Reduces infection and protects against bodily

fluids. A gown, a mask, and eye protection
6. Wash hands and don gloves and should be worn if there is a lot of drainage or if
facemask. the incision is infected. If the drainage is foul-
smelling, the nurse will benefit from wearing a
mask.

7. Provide client privacy. Folow To maintain client’s dignity. Appropriate

appropriate infection control procedures. procedures ensure the safety of the client.

8. Assist the client to a comfortable position

in which the wound can be readily Patient positioning and use of a bath blanket
exposed. Expose only the wound area, provides comfort and warmth.
using a bath blanket to cover the client, if Provides privacy and prevents chilling.
necessary.
9. Before removing inner dressings, ensure
Reduces transmission of infection and
that your hands are cleaned.
microorganisms.
a. Remove binders, if used and
placed them aside.
b. If adhesive tape was used, To prevent accidental injury to the wound.
remove it by holding down the Helps reduce patient discomfort during removal
skin and the tape gently but of dressing.
firmly towards the wound.
To help ease removal. Moistening the tape with
c. Use solvent to loosen the tape if acetone or a similar solvent lessens the
required. discomfort, particularly from hairy surfaces.

d. Remove outer dressings. Reduces the transmission of microorganisms

The appearance and odor of the drainage may be

e. Lift the dressing to the underside
upsetting to the client.
away to the client's face.

10. Disposed soiled dressing appropriately.

Dressings with body fluids are considered
a. Place the soiled dressings in the
contaminated and subject to biohazard disposal
moisture proof bag without
in the correct manner per institution.
touching the outside bag.
b. Remove gloves, dispose them in
the moisture proof bag and wash Prevents spread of microorganisms.
your hands.
11. Remove inner dressings.
Supplies are within easy reach, and sterility is
a. Don sterile gloves. Open sterile
maintained.
dressing set, using surgical
Sterility of dressings and solution is maintained.
aseptic technique.

Sterility prevents possible infection. Using of

b. Place the sterile drape. Remove
forceps is used to grasp, retract, or stabilize
under dressings with forceps.
tissue in he wound.

c. Assess the appearance, location,

odor of wound, & the diameter of To evaluate for signs and symptoms of infection
drainage collection on the or tissue trauma.
dressings.
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 Once the forceps has been used, do not
d. After the dressing is removed,
reintroduce the used applicator into the sterile
discard the forceps, or set aside
solution because this will contaminate the sterile
from the sterile field.
solution.
12. Clean the wound, if indicated.
a. Clean the wound using a new
pair of forceps, and moistened
swabs. Dried blood or drainage on the surrounding skin
• Incision - moving from top to bottom, can be an irritant and a medium for microbes.
clean incision line first. Clean each side
of incision, using new gauze for each
swipe.

This prevents contamination by fluid travelling

b. Keep the forceps lower than the
up to the handle and the nurse’s wrists and back
handles at all times.
to the tips.

Assessment includes noting signs of infection as

evidenced by redness, swelling, purulent
13. Assess the over-all appearance of the drainage, or unusual tenderness; signs of tissue
wound. trauma as evidenced by swelling or ecchymosis;
and evidence of bleeding or leakage of tissue
fluids from the site.

14. Apply new sterile dressings.

a. Apply sterile dressings one at a
The procedure includes cleaning, disinfection
time over the wound using sterile
and protection of the wound while respecting the
gloves or forceps. Start at the
rules of hygiene.
center of the wound and move
progressively outward.
b. Remove and discard gloves.
Reduces transmission of microorganisms.
Wash hands.
15. Secure dressings with tape, tie tapes, or a
binder.
a. Place the tape so that the If the process of placing the dressing is done in a
dressings cannot be folded back smooth fashion and small portions at a time, less
to expose the wound. Place strip wrinkles and better adherence will occur.
at the end of the dressing, and
space tapes evenly in the middle.
To prevent and minimize infection.
b. Ensure the tape is not long and To prevent strain on the wound.
wide to adhere to the skin. Place To be able to fix the recurrent turns well, not only
the tape in the opposite direction the wound, but the entire length of the blunt body
from the body action. part should be covered.

16. Conduct client/family education about

the dressing, which may include teaching Educates the client/family and prepares for
the dressing technique to the discharge.
client/family
Recording important data such as the dressings,
appearance of wound, date, and time provides
17. Documents the dressings, appearance of
communication and demonstrates adherence to
wound, date, and time it was changed.
plan of care.

Recovering in the hospital

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Childbirth is an exciting time. The mother finally get to meet the baby who’s been growing inside of
the mother for the last nine months. Yet having a baby can also be taxing to the mother’s body,
especially if the mother had a cesarean delivery (C-section).

The mother will probably be in hospital for 3 or 4 days after a caesarean section, and may need to take
things easy for several weeks.

Recovering in hospital:

The average stay in hospital after a caesarean is around 3 or 4 days.

The mother may be able to go home sooner than this if both the mother and her baby are well.

While in hospital:
• The mother will be given painkillers to reduce any discomfort
• She will have regular close contact with her baby and can start breastfeeding
• She will be encouraged to get out of bed and move around as soon as possible
• She can eat and drink as soon as she feels hungry or thirsty

When the mother is well enough to go home, she will need to arrange for someone to give her a lift as
she will not be able to drive for a few weeks.

Looking after the wound:

• Gently clean and dry the wound every day

• Wear loose, comfortable clothes and cotton underwear
• Take a painkiller if the wound is sore – for most women, it's better to take paracetamol or
ibuprofen (but not aspirin) while you're breastfeeding watch out for signs of infection

Non-dissolvable stitches or staples will usually be taken out by the midwife after 5 to 7 days.

Incision Care at home:

If the mother goes home with a dressing (bandage), change the dressing over your cut once a day, or
sooner if it gets dirty or wet.

• The health provider will tell the mother when to stop keeping the wound covered.
• Keep the wound area clean by washing it with mild soap and water.
• The mother may remove her wound dressing and take showers if stitches, staples, or glue were
used to close your skin.
• Do not soak in a bathtub or hot tub, or go swimming, until the provider says that it is OK. In
most cases, this is not until 3 weeks after surgery.

If strips (Steri-Strips) were used to close your incision:

• Do not try to wash off the Steri-Strips or glue. It is OK to shower and pat your incision dry with
a clean towel.
• They should fall off in about a week. If they are still there after 10 days, you can remove them,
unless your provider tells you not to.

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After having a baby by C-section, it’s normal to experience pain, soreness, and even bleeding. After all,
the mother just had major abdominal surgery and of course the body needs time to recover. It also means
the mother needs to be more aware of what she can and can’t do as her body heals.

References:

Book:
A. (2021a). Delmar’s Fundamental & Advanced Nursing Skills by Altman,Gaylene. [2003,2nd

Edition.] Paperback. DeIma-Cengage.

Msn Rn, P. L. B. (2018). Taylor’s Clinical Nursing Skills: A Nursing Process Approach (5th

ed.). LWW.

Sites:
Stanford Children’s Health. (n.d.). Stanford Children’s Health.

https://www.stanfordchildrens.org/en/topic/default?id=cesarean-delivery-92-P07768

Higuera, V. (2020, January 28). C-Section Scars: What to Expect During and After Healing.

Healthline. https://www.healthline.com/health/pregnancy/c-section-scar

Krans, B. (2018, July 17). C-Section (Cesarean Section). Healthline.

https://www.healthline.com/health/c-section#risks

Dubin, A. (2019, September 17). C-Section Scar Care: Your Guide to Helping It Heal. Parents.

https://www.parents.com/pregnancy/giving-birth/cesarean/c-section-scar-care/

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