Objective To explore the effect of heart-shaped suture combined with absorbable collagen suture after cesarean section in patients with scar uterus and its effect on wound healing. Methods A total of 66 patients with scar uterus who underwent cesarean section in our hospital from October 1, 2021 to September 30, 2022 were randomly divided into control group and observation group, with 33 patients in each group. The control group was treated with traditional "U" type suture subcutaneous fat layer by ordinary 2-0 synthetic absorbable surgical suture, and continuous intradermal suture skin by 4-0 synthetic absorbable surgical suture. The observation group was treated with heart-shaped tension suture fat layer by ordinary 2-0 synthetic absorbable surgical suture, and continuous intradermal suture skin by 2-0 absorbable collagen line. The operation-related indicators, satisfaction and complications were compared between the two groups. Results The wound suture time and wound healing time of the observation group were shorter than those of the control group, and the VAS score was lower than that of the control group, the differences were statistically significant (P <0.05). The satisfaction rate of the observation group was 90.91%, which was higher than 69.70% of the control group, and the difference was statistically significant (P <0.05). The incidence of complications in the observation group was 3.03%, which was lower than 21.21% in the control group, and the difference was statistically significant (P <0.05). Conclusion The effect of heart-shaped suture combined with absorbable collagen suture in patients with scar uterus after cesarean section is good. It can effectively promote the rapid healing of abdominal incision, relieve pain, promote postpartum recovery, reduce the risk of postoperative complications, and improve patient satisfaction, which is worthy of clinical application..