Impact of Subcutaneous Tissue Closure Techniques During Primary Cesarean Section on Postoperative Wound Complications: A Narrative Review

Abstract

Postoperative wound complications are one of the major issues after cesarean section, with reported rates ranging from 3% to 30%. The apparent advantage of closing the subcutaneous layer is the reduction of wound tension and the obliteration of dead space in which serous fluid and blood may collect, resulting in infection and wound disruption. Continuous and interrupted subcutaneous suturing are commonly used techniques. The continuous technique uses a single uninterrupted suture and distributes tension evenly across the wound, whereas the interrupted technique uses individually tied stitches and allows point-by-point adjustment of tension. Published studies have examined wound infection, seroma, hematoma, wound separation, postoperative pain, operative time, and cosmetic outcome, but the overall impact of each technique remains influenced by obesity, glycemic control, subcutaneous tissue thickness, suture material, surgical asepsis, and surgeon preference. This narrative review discusses the rationale for subcutaneous tissue closure, the technical characteristics of continuous and interrupted suturing, their potential effects on post-cesarean wound complications, and the clinical factors that should guide selection of the closure method.