Caesarean section is the most common surgery performed worldwide. Currently, approximately 15 % of pregnant women worldwide deliver by caesarean, and this prevalence is on the rise.​^1,9.​A great variety of materials and techniques are used for skin closure after caesarean section and there is a need to identify which provide the best outcomes for women. Skin closure can be carried out with stitches that go under the skin and stitches that go over the skin or staples /clips. Suture materials currently available are natural or synthetic, absorbable or non-absorbable, single-filament or braided. Staples are attractive because of the speed of application.⁷Two methods of skin closure used frequently in routine practice are metallic surgical staples and absorbable subcuticular sutures. The method chosen relies on the surgeon’s preference. There is not enough evidence from the included studies to say which method of closing the caesarean skin incision is superior.The impact of these methods on postoperative pain, skin closure time, aesthetic results, wound dehiscence and infections remain controversial.​²â€‹Wound complications following caesarean delivery result in significant morbidity.⁸Wound complication, including infection, separation, and fluid collection, is an expensive complication and poses a significant burden to the patient, affecting 3% - 16% of patients undergoing caesarean⁶. Therefore, it is of importance to determine the most effective and safest closure method with which to decrease patient morbidity. There exists in the literature a longstanding debate regarding the superiority of primary suture versus staple closure in terms of wound complication, closure time and aesthetics.It is postulated the sutures act as foreign material and cause tissue damage, increasing the risk of infections.​The use of prophylactic antibiotics to reduce infection was not reported in most trials.^{3, 7} Wound complications include wound infection, discharge, gaping, disruption, hematoma formation, seroma formation and wound dehiscence.

Initial small studies regarding caesarean skin closure materials examined operative time, pain scores, cosmesis scores and/or patient satisfaction and yielded contradictory findings.​^{4, 5}​One randomized controlled trial of wound disruption or infection(evaluated by phone interview supplemented with record review) at 2-4 weeks as the primary outcome, suggested increased rates with staple as compared to suture closure.​⁶​Studies have also compared other parameters between different skin closure techniques. These are suturing time, post op pain, patient satisfaction arte and cosmetic appearance of skin. Given the paucity of trials that adequately examined wound complication outcomes of skin closure methods in caesarean delivery, we propose a study to compare wound complicationrates between surgical staples and the subcutaneous suturesfor skin closure in caesarean section. We will also compare other parametersincluding skin closure time, postoperative pain and patient satisfaction rate between the two techniques used for skin closure.