After the placenta is delivered, the surgeon closes the incision in layers. They first stitch up the woman's uterus with dissolving sutures (the uterus is often lifted out of the woman's abdomen to do this). Then the uterus is replaced and the abdominal muscles are allowed to move back in place, to cover the uterus. The fat layer of tissue over the muslces is then stitched with dissolving stitches, before the top skin layer is stitched. The skin is stitched with either separate stiches that can be seen on the skin or one long continuous stitch that is threaded completely under the woman's skin (these can either be dissolving stitches or ones that need to be removed at some stage). The 2 ends of the continuous stitch are looped across the outside of the skin and knotted together in the middle of the incision line, to prevent them disappearing under the skin.
A few caregivers still use separate small metal staples to hold the skin together. The type of stitches (or staples) used will depend on the preference of the surgeon. You may wish to ask the surgeon what they intend to use, and possibly inform them, if you have skin allergies to metals.
Some surgeons will insert a wound drain into the incision as they are stitching. This is a small, plastic tube about 5 to 7 millimetres wide that sits under the skin and drains away small amounts of excess blood that could collect under the incision after the operation. Usually up to 50 to 100 mls can drain away. The end of the drain is attached to a small plastic bag or container that collects the blood. The drain is usually removed a day or two after the operation, or when the surgeon feels the amount of blood coming away is minimal.