Patchwork Girl presents its readers with a creation put together the wrong way 'round, so that its seams are on the outside, for the reader to see (the ambiguity in this sentence is intentional; both the work itself and the title character show their stitching). Like the character, the work is simultaneously hideous (both are covered in scars) and fascinating (because scars imply a past, a history, information).
Shelley Jackson equates the seams that hold the patchwork girl together with the links that hold Patchwork Girl together. A seam's purpose is to join together two pieces of material that were not previously joined. Translated to the realm of literature, a seam could be interpreted as the author's joining of various elements of her work. Traditionally, such seams are treated the way a tailor treats the seams of a piece of clothing: they are made inconspicuous, blended in with the rest of the work, made indistinguishable from the overall texture. For a tailor to use brightly colored thread to stitch together dark fabrics or for an author to move between ideas without a smooth segue is commonly considered "bad craft".
In sewing, however, the seams are as important (if not more so) than the fabric itself. The same is true for hypertext: its strength lies in its ability to juxtapose (Jackson uses it in part to shuttle between narrative and criticism). It is the seam which allows the patchwork to exist and allows the "patchwork paradigm" of an evolving creation rather than one set in stone or paper (one can get a feel for the piecemeal nature of Patchwork Girl's creation by comparing the earlier, more "primitive" version found in the Brown University's Storyspace cluster with the "published" version available through Eastgate).