RT Book, Section
A1 Roses, Robert E.
A1 Morris, Jon B.
A2 Zinner, Michael J.
A2 Ashley, Stanley W.
A2 Hines, O. Joe
SR Print(0)
ID 1160037905
T1 Incisions, Closures, and Management of the Abdominal Wound
T2 Maingot's Abdominal Operations, 13e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9780071843072
LK accesssurgery.mhmedical.com/content.aspx?aid=1160037905
RD 2024/09/08
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.