Impact of superficial fascial suture on early postoperative pain after cesarean section: a single-center observational study

OBJECTIVES: This study aimed to clarify the association between superficial fascia sutures in cesarean section and postoperative pain. MATERIAL AND METHODS: We conducted a single-center, retrospective observational study of pregnant women who underwent cesarean section at Gunma University Hospital. The patients were classified into two groups according to the presence or absence of superficial fascial sutures, and the Numerical Rating Scale (NRS) pain score at rest and with movement at 24, 48, 72, and 96 h after delivery was used as the primary endpoint. A pain score of 5 or higher was defined as moderate to severe pain, and multivariate logistic regression analysis adjusted for confounding factors was performed. RESULTS: At 24 and 48 h postoperatively, the NRS score was significantly higher in the superficial fascial suture group than in the non-sutured group (at rest: p = 0.004 and p = 0.01, respectively; with movement: p = 0.001 and p = 0.015, respectively). No differences were observed between the groups at 72 and 96 h. Multivariate analysis revealed that superficial fascial sutures were an independent risk factor for pain augmentation. CONCLUSIONS: Superficial fascial sutures may be associated with increased pain 24-48 h after delivery. Therefore, clinicians should recognize this potential trade-off when selecting closure techniques.