abdominal incision and abdominal anatomy
TRANSCRIPT
Knowledge anatomy is essential to avoid or secure major vessels to enhance appropriate repair, so as to reduce the risk of incisional or
wound dehiscence
Category of incision
MidlineTransverse
Transverse Incisions
Maylard incisionPfannenstiel IncisionCherney incisionKustner incision
Maylard’s Incision
Made 2 fingerbreadths above the symphysis pubis (appr. 3-4 cm)
Carried down through the subcutaneous fat and through Scarpa’s fascia
Transverse Incisions; Maylard Fascia overlying the abdominal
wall muscles is identified
Scarpa’s fascia covers the sheath of the rectus
Rectus muscle now could be seen clearly
Lower portion of the rectus sheath is dissected from rectus belly
Pfannenstiel Incision
Cherney Incision
The incision affords less exposure than the Pfannenstiel and almost no extensibility.
Median Incision
Midline Incision
Advantages 1.It is almost bloodless2.No muscle fibres are divided3.No nerves are injured4.Good access to the upper abdominal viscera5.It is very quick to make as well as to close6.A midline epigastric incision also can be extended the full length of the abdomen curving around the umbilical scar
Closing the abdomen
Caesarean Section