Closure of Pfannenstiel skin incisions in cesarean sections: comparison of wound outcomes with interrupted mattress vs. subcuticular suture

Anjali Choudhary, Neeta Bansal, Priyanka Chaudhari


Background: Cesarean section is by far the commonest surgery performed worldwide. Most of these surgeries are performed by Pfannenstiel incision. Various techniques and material have been tried for skin closure in these surgeries. Each method has its own advantages and disadvantages. The objective of the study was to compare wound outcomes in Pfannenstiel incisions closed in interrupted mattress sutures and subcuticular suture with absorbable material, in a prospective study of cesarean deliveries.

Methods: It was studied that 104 women who had cesarean sections with Pfannenstiel incision prospectively for wound outcomes in terms of wound complications (hematoma formation, infection, nonunion, dehiscence and need for resuturing), pain and cosmetic appearance in two groups. One with absorbable subcuticular sutures, another with interrupted mattress suture.

Results: Women who had subcuticular stitches had less postoperative pain, better wound outcomes, faster recovery, early discharge from hospital and cosmetically superior scars as compared with interrupted mattress sutures.

Conclusions: While search for the best method and material for skin closure continues, the subcuticular suture with an absorbable material seems to leave a cosmetically better scar with lesser wound complications.


Interrupted mattress stitch, Pfannenstiel incision, Skin closure, Subcuticular suture, Wound outcome

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