Cesarean section (C-section) is one of the oldest and common obstetric procedures. Globally, childbirth through c-section is on the rise and more than 29.7 million c-sections are performed every year. It is a major surgical procedure that requires incision to the lower abdomen from skin deep to uterine wall. The c-section scar heals by leaving a definite scar at the site of incision, causing significant cosmetic disfigurement. Other adverse events associated with c-section scar include pain, pruritus, colour changes, stiffness, thickness, irregularity and patients’ dissatisfaction. Good skin closure requires reduced mechanical tension, proper edge adaptation and absence of suture marks.
Along with post-operative chronic pain, post-operative cosmetic deformity is an important women health issue. Scar formation is a natural healing process to mend the damaged part of the body. Cosmetic disfigurement may result in sexual dysfunction, emotional stress and impaired intimate relationship. Sometimes, raised c-section scar (keloid) and hypertrophic scar may develop, adding to the cosmetic deformity. Keloids may develop into lumps, giving an uglier look. On the other hand, hypertrophic scar results in thicker, firmer and raised scar; however, it does not overgrow the borders of the incision. Sometimes, scars may be of sunken or pitted appearances when the underlying supporting structures are lost. With the advancement of biotechnology, surgeons adopt certain techniques while closing the wound (e.g., intradermal buried vertical mattress) to provide better cosmetic outcome than that of conventional sutures.
C-section scars can be managed in various ways. Some important methods of treatment include topical treatments, surgical procedures, steroid injections, radiotherapy, dermabrasion, filler injections and micro-needling. C-section, scars may cause chronic pain, affecting the daily routine and quality of life. Studies have reported that when microcurrent point stimulation (MPS) is applied to the scars, it helps alleviate chronic pain. Microcurrent therapy is also valid for the treatment of other pain syndromes.