What is the difference between horizontal cutting and vertical cutting? Which one is better?

We all know that many pregnant mothers will choose cesarean section when giving birth. Cesarean section is a common way of delivery. According to the different surgical methods, it can be divided into two types: horizontal incision and vertical incision. Some pregnant mothers have horizontal incision, and some have vertical incision. So which one recovers faster? Let's take a closer look!

Which one recovers faster, horizontal or vertical cutting?

The horizontal incision is located in the lower abdomen and has a small wound area, so postpartum recovery is faster, but postoperative adhesions are prone to occur; while the vertical incision has a larger wound area, so the wound heals more slowly, but the advantage is that the chance of postoperative adhesions is low.

1. Transverse incision

The transverse incision is the traditional method of cesarean section. The incision is located about 2 fingers above the pubic symphysis. The incision is relatively low and the wound can be hidden below the waistband. Therefore, the transverse incision of cesarean section is also called "bikini cut". See the figure below for details.

The direction of the transverse incision is consistent with the striated muscles of the abdomen, but it increases the exposed area of ​​the rectus abdominis muscle and increases the incidence of parietal peritoneal adhesion during surgical suturing.

Moreover, the time for transverse incision surgery and laparotomy is longer than that for vertical incision cesarean section, so transverse incision is usually not suitable for emergency cesarean section. The only advantage of transverse incision is that it does not affect the appearance.

2. Vertical incision (longitudinal incision)

Many mothers are reluctant to use vertical incisions, mainly because vertical incisions leave larger scars. The wound of a horizontal incision is generally about 10 cm, while the wound of a vertical incision may reach about 12 cm. If it is an emergency cesarean section, the wound may be larger.

The direction of the vertical incision is slightly to the side of the midline of the abdomen, from below the umbilicus to between the pubic symphysis. From the perspective of human anatomy, the probability of iatrogenic injury caused by a vertical incision during cesarean section is very small because the direction of human nerves and blood vessels is longitudinal.

The advantage of vertical incision is that the opening area is large, the doctor's field of vision is better, and the fetus can be removed in time. At the same time, the probability of intrauterine adhesion is also lower. But the disadvantage is that the wound is easily pulled and painful, and the scar is more obvious and unsightly.

What is the difference between a horizontal incision and a vertical incision for a caesarean section?

1. The urgency of the surgery is different

A normal caesarean section will use a transverse incision, and a vertical incision will only be chosen in special circumstances, such as when the fetus's head is too large and the transverse incision cannot be used for smooth delivery.

If the fetus is severely hypoxic or the mother's condition is very critical, an emergency cesarean section is required to deliver the fetus. A vertical incision allows the doctor to see more clearly, which can shorten the operation time and speed up the delivery process.

2. Different incision directions

As the name suggests, a horizontal incision is a horizontal opening made in the abdomen of the parturient, and a vertical incision is a vertical opening made in the abdomen of the parturient.

3. Scars have different aesthetics

The position of the transverse incision is relatively low, at the bottom of the uterus. The wound follows the growth direction of the skin texture and is easy to suture. The sutured cosmetic thread does not need to be removed. After the wound recovers, the scar is more beautiful.

Vertical incision requires stitches removal. If the mother has a scar-prone constitution, the scar will easily proliferate, forming a curved and ugly scar.

What to pay attention to after cesarean section

Bed position

Since most caesarean sections use epidural anesthesia, the patient should rest in a supine position without a pillow for 6 hours after the operation, and can change to a semi-recumbent position after 6 hours.

rest

Due to the surgical trauma and the effects of anesthetics, the mother will be very tired after the operation and needs to rest. She should not talk to too many people. If the child is crying, you can temporarily take the child away so as not to disturb the mother's rest.

diet

Do not eat or drink for 6 hours after surgery, because at this time, due to the effect of anesthetics, gastrointestinal function has not yet recovered, and there is gas in the intestine that needs to be discharged. Generally, you can drink some water after 6 hours, and you can eat some liquid food after 8 hours. After the intestinal peristalsis is restored, you can eat some semi-liquid food.

Get out of bed as soon as possible

Getting up and moving around can promote intestinal peristalsis, prevent intestinal adhesions, facilitate the discharge of lochia, and help restore urination function as soon as possible.

Observe the discharge of lochia

Generally, after surgery, lochia is discharged from the birth canal, and its amount is roughly equivalent to the amount of menstruation. If there is excessive bleeding from the birth canal, you should inform the medical staff in time.

Preventing infection

The mother is weak and has a weak resistance. Therefore, she should pay attention to food hygiene, avoid catching cold, and avoid being infected with other diseases. Take good care of the wound. If there are symptoms of vomiting and coughing, try to press the wound with your hands to avoid infection.