TY - CHAP M1 - Book, Section TI - Incisions, Closures, and Management of the Abdominal Wound A1 - Roses, Robert E. A1 - Morris, Jon B. A2 - Zinner, Michael J. A2 - Ashley, Stanley W. A2 - Hines, O. Joe PY - 2019 T2 - Maingot's Abdominal Operations, 13e AB - The planning, execution, and closure of an incision have an enormous impact on the outcome of an abdominal operation. The high combined incidence of surgical site infection, wound dehiscence, and hernia formation suggests a dominant contribution of wound complications to surgical morbidity. Moreover, the quality of exposure provided by an incision influences outcome in ways that defy easy quantification. An incision must provide access to the site of abdominal pathology and allow ready extension if greater exposure is required. Indeed, the adequacy of an incision is determined above all else by the safety with which an operation can be undertaken. Nothing should compromise this, and a larger incision or even, on occasion, a second incision, should be created without hesitation if exposure is inadequate. Notwithstanding this, the incision should be executed in a fashion that anticipates a secure wound closure and interferes as little as possible with the function and cosmesis of the abdominal wall. While the vertical midline incision remains most popular and is, perhaps, the most versatile, a variety of other incisions may have distinct advantages in specific settings. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/07 UR - accesssurgery.mhmedical.com/content.aspx?aid=1160037905 ER -