**5. Conclusion: how to perform a CS in 2021**

Taken together all aspects which influence the risk of a defect scar healing, we advise to perform a CS as following:


Personal opinion of the authors: We recommend to perform a double layer suture with single stitches of the first layer and a continuous unlocked second layer including the superficial muscle layer and the peritoneum viscerale.

8.Closure of the peritoneum parietale may be advantageous.
