Selection of the appropriate incision technique is one of the main preconditions for a complicationfree healing process involving minimum esthetic impairment. The purpose of this paper is to identify various types of abdominal incisions that make certain surgical procedure a bit easier, and to avoid unnecessary long. Hip replacements can be preformed through a direct anterior approach, an anterior lateral approach, a lateral approach, a posterior approach, and a superior approach. A variety of ventral and dorsal incisions are used to gain access from the upper cervical to the lower sacral spine.
The specific surgical incision will depend on the underlying pathology, site, patient factors, and the surgeons preference. One of the most common types of incisions is the midline incision. Incisional wound model fullthickness skin incisions 3 cm in length were made on the dorsum of each animal. Surgical incisions, in general, are getting much smaller. The decision to select a specific incision would depend on the several elements. Abdominal surgical incisions gridiron pfannenstiel geeky medics. Since wound classifications serve as a formula to grade the extent of microbial contamination postoperatively, proper documentation of wound classifications can help to know about the possibility of developing an infection at the surgical site.
In surgical practice, deciding on the right type of surgical access for a specific condition would be a skill of its own for a surgeon. Surgical incisions and their anatomic basis springerlink. Incision through the umbilicus has no negative effect on wound healing. Ideally, the surgical incision should minimize the sacrifice of nerves, particularly those supplying the abdominal musculature. Abdominal incisions and sutures in obstetrics and gynaecology. It is a variation of the more common mcburney incision also known as gridirons incision. Appropriate positioning plays an important role in minimizing blood loss and providing adequate exposure of the spine. How to document surgical wound classifications properly. The surgical incision and the resultant wound represent a major part of the morbidity of the abdominal surgery. This document contains information andor instructional materials developed by the university of michigan health system umhs for the typical patient with your condition. New surgical techniques and surgical site infections.
Surgical wound classification is the most circulated nurse document within a patients record once the surgical procedure is over. A pfannenstiel incision offers more exposure than a kustner incision. Suture care postoperative instructions 2 disclaimer. Also known as the laparotomy incision, or celiotomy, this is the most traditional of surgical incisions. Sutures can be divided into two types those which are absorbable and will break down harmlessly in the body over time without intervention, and those which are nonabsorbable and must be manually removed if they are not left indefinitely.
Instead of having one incision that is four inches long, you may have three or four that are less than an inch long. Pdf in an effort to achieve inconspicuous scars, plastic surgeons try to place their incisions in established creases and folds of the skin. Incisions and tissue management in periodontal surgery raphael borchard, heinz erpenstein periodontal surgery is an essential part of modern periodontal therapy. There are three major types of abdominal inci sions through which pelvic surgery can be per formed. It should be the aim of the surgeon to employ the type of incision considered to be the most suitable for that particular operation to be performed. Surgical incisions, positioning, and retraction neupsy key. The different types of surgical incisions are often named after the surgeon who designed them or after the anatomical structures that they display. Surgical access incisions statpearls ncbi bookshelf. Principles of incision and wound closure fuad ridha mahabot 1 2. Some surgeons will use 2 incisions, both the anterior and superior approach. Preoperative planning is required to achieve optimal cosmetic and functional results after making a skin incision. Surgical site infections after minimally invasive cardiac surgery pose a challenge to the clinician. Comparison of cutaneous incisions to approach the infraorbital rim and orbital floor article pdf available in brazilian journal of oral sciences 82 april 2009 with 105 reads.
Lower abdominal incisions can also be midline, paramedian or pfannenstiel incisions. Incisions and tissue management in periodontal surgery. Surgical approach types hip replacement elvis grandic, md. Incisional pain can occur with any type of surgery, from wisdom teeth extraction to caesarian sections, to cardiac surgery. Comparative healing of surgical incisions created by the. Table 1 shows the patient demographics 26 cases were treated using type a incisions, 59 cases using type b, 20 cases using type c and six cases were treated using type d incisions and the tumor staging determined based on the american joint committee on cancer staging system. Cutting and dissecting instruments 7 handle with 15 blade deep knife used to cut deep, delicate tissue. One unpleasant side effect is incisional pain, or pain or itchiness at the site of the surgical incision. In abdominal surgery, the routinely used incisions include the lanz incision, midline and paramedian incisions, and the kocher incision. Surgical instruments the basic instruments that every beginner surgeon should know are placed in four categories.
As most urological operations can be performed via many different approaches, the surgeon must combine understanding of all alternatives with the flexibility to choose the incision most appropriate to each clinical situation. A surgical patient often faces a wide range of risks and side effects. Abdominal incisions scandinavian journal of surgery. Surgical incisions if this is your first visit, be sure to check out the faq by clicking the link above. The purpose of any surgical incision is facilitation of the planned operation with the least possible morbidity. In general, a surgical incision is made as small and unobtrusive as possible to facilitate safe and timely operating conditions. They are used to dissect, incise, separate, or excise tissue. Physical findings of sternal instability and sternal click of the median sternotomy cannot be applied to many incisions used in minimally invasive cardiac surgery figure 1. Three main types of suture include the nonabsorbable, slowly absorbable, and the.
Pdf comparison of cutaneous incisions to approach the. Part number description quantity 205040 straight rod whex and taper, 40mm 200111 2 205050 straight rod whex and taper, 50mm 2 205060tm straight rod whex and taper, 60mm 2 205070 straight rod whex and taper, 70mm 2 205080 straight rod whex and taper, 80mm 2 205090 straight rod whex and taper, 90mm 2 205100 straight rod whex and taper, 100mm 2. Clinical comparison of four types of skin incisions for. The type of suture used varies on the operation, with the major criteria being the demands of the. The upper abdominal incision gives good access to the viscera in the upper abdomen and this incision can be combined with a thoracotomy for oesophageal surgery. It may include links to online content that was not created by umhs and for which umhs does not assume responsibility.
The healing process causes wound contraction and scarring, which can compromise function and appearance this chapter describes practical concepts to help achieve optimal results from surgical incisions. The second ophthalmologists assessment scores were 2. Chapter 169 surgical incisions, positioning, and retraction mehmet zileli, edward c. How to monitor a surgical incision during healing background the normal healing process of any wound involves mild in. In surgery, a surgical incision is a cut made through the skin and soft tissue to facilitate an operation or procedure. Shawn odriscoll, md, phd mayo foundation, ken yamaguchi, md washington university, barnes jewish hospital graham king, md, msc university of western ontario 2 table of contents table of contents latitude total elbow prosthesis p. Indmedica journal of the anatomical society of india.
There are quite a few variations for this type of an incision. Surgical incision is a cut made through the skin to facilitate an operation or precedure. The plasmablade is a promising new surgical instrument that provides atraumatic, scalpellike cutting precision and electrosurgicallike. This article discusses the anatomy of the abdominal wall, anatomy of the rectus sheath and common types of abdominal surgical incisions. Norman and bramley 1990 have given certain general guidelines for incisions. A surgical incision is an aperture into the body to permit the work of the operation to proceed. Once the skin is incised, the uterus is also incised vertically, and the baby. Surgical incisions are most effective when they follow the natural lines of tension in the human anatomy, called langers lines. The incision must provide ready access and adequate exposure for the anticipated procedure as well as allow for extension, if necessary, for the performance of an unanticipated procedure. Laparoscopic, or minimally invasive keyhole, incisions are much smaller than the traditional open incision and are just large enough to allow surgical instruments to be inserted into the body. An attempt is being made to discuss the anatomical basis for various surgical incisions in the human body of which this paper is a part pertaining to the head and neck region. Often, multiple incisions are possible for an operation.
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