Cesarean deliveries are common, and most incisions heal without complication. However, factors like obesity, diabetes, or infection can lead to poor healing or the opening of the incision, known as wound dehiscence. When these complications arise, specialized intervention is needed. This often involves a medical device called a Wound VAC (Vacuum Assisted Closure), or Negative Pressure Wound Therapy, which manages complicated surgical sites and encourages recovery.
Understanding Wound VAC Therapy for Post-C-Section Incisions
The Wound VAC system applies subatmospheric pressure, or negative pressure, directly to the wound bed. This therapy uses a specialized foam dressing placed into the open wound, covered with an airtight adhesive film. A tube connects this sealed dressing to a portable vacuum pump and a collection canister. The pump continuously or intermittently draws fluid away, stabilizing the wound environment.
This device is reserved for post-C-section incisions that have developed complications, such as a surgical site infection or separation of the incision layers. The negative pressure accelerates healing through multiple functions. It pulls the edges of the open wound closer together, reducing the overall wound size. The constant suction removes excess fluid (exudate), which often contains inflammatory components that hinder recovery.
Removing this fluid reduces swelling around the incision, which improves blood flow to the tissue. Increased blood flow delivers more oxygen and nutrients, stimulating the formation of granulation tissue. This healthy, new tissue is the foundation needed for the wound to close completely. Applying mechanical stress directly to the tissue also promotes cell growth, speeding up the recovery process.
Determining the Duration of Wound VAC Treatment
The total duration of Wound VAC therapy after a C-section is highly variable and depends on the individual wound’s characteristics and healing progress. There is no fixed time frame; the device is worn until the surgical site meets specific clinical criteria for removal. For complicated, open wounds resulting from infection or dehiscence, treatment often lasts anywhere from a few weeks to a month or more.
For open wounds, treatment duration varies widely; some women require the device for around three weeks, while others with more complex wounds need it for longer periods. In contrast, when a Wound VAC is used preventatively over a closed, high-risk incision, it is left in place for a much shorter period. This preventative application typically lasts just three to seven days post-surgery to manage swelling and fluid accumulation in the initial healing phase.
The decision to discontinue therapy is made by healthcare providers based on regular wound assessments, with dressing changes typically occurring every two to three days. A significant indicator of progress is the consistent formation of healthy, beefy red granulation tissue across the wound bed. Other measures include the reduction in wound size and the decrease in the volume of drainage collected in the canister. If the wound shows at least a 15% reduction in area within the first one to two weeks, the treatment is usually considered effective and continued. If no progress is observed, the healthcare team will reassess the treatment plan.
Practical Management and Transitioning Off the Device
Since the Wound VAC must be worn nearly 24 hours a day to be effective, patients often manage the portable device at home. The system’s pump and collection canister allow for mobility, but patients must monitor the fluid level and ensure the battery remains charged. The device includes alarms that alert the user to common issues, such as a loss of the airtight seal, a kink in the tubing, or a full collection canister.
While the suction itself is generally not painful, patients should be aware that periodic dressing changes can cause discomfort, especially when removing the adhesive film. Taking a prescribed pain reliever about 30 minutes before a scheduled dressing change can help reduce this sensation. Patients must seek immediate medical advice if signs of a complication develop, such as a persistent fever, sudden increase in pain, or warmth and redness spreading from the incision site.
When the wound has sufficiently granulated and is ready for the next stage of healing, the healthcare provider will remove the device. This marks the end of the negative pressure therapy phase. Following removal, the wound is typically managed with simple dressings to allow for final healing by secondary intention. If the wound bed is clean and healthy, the medical team may perform a minor surgical procedure to close the remaining wound edges, known as secondary closure.