Incision closure and management of the Abdominal wound
Incision , closure , and management of the Abdominal wound
• Accessibility • Flexibility • Security
Types of incision : ﺩﺳﺘﻪ 4 • • A- Vertical B- Transverse and oblique C- Abdominothoracic D- Retroperitoneal or extraperitoneal
A- Vertical • Midline Medial lateral • Paramedian • (0%incisional hernia)
• Anew incision should never be made closely parallel (within 5 cm)to the site of any pre vinous incision
Cold blade scalpel • Elecctrocautery • ﻋﻮﺍﺭﺽ ﻧیﺰ Quicker-lessblood loss- less pain • . ﺗﻔﺎﻭﺗی ﻧﺪﺍﺭﺩ
Midline • Upper midline • Mid midline • Lower midline X to P incision
Ruther ford – morrison MC Burney
Pfannestiel incision • Genycologic • Extra anatomical retropubic prostatectomy
• • Closure peritonem Closure fasia Closure subcutaneous Closure skin
• Closure Layers en mass
Continus running suture
• Monofilament non absorbale • PDS
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