SURGICAL INCISIONS

-

S

 

urgical incision is a cut made into the body so as to facilitate an operation or procedure. The 3 essential things should be achieved while doing so – Accessibility, extensibility and a reliable closure.


The incision should be long enough for good exposure with keeping in mind the vessels and nerves are not damaged and a good closure is achieved by the end of the procedure. Splitting of the area is more appreciated rather than the cutting of the tissue. Transverse incisions are always better than vertical incisions and retraction of the muscles or other tissues should be done in the direction where there is neurovascular bundle.

The choice of incision depends upon the –

1.    Type of surgery (elective/emergency)

2.    Target organ

3.    Previous surgeries

4.    Surgeons preference and experience.

An ideal incision is the incision which allows easy access to the desired organs or tissues with minimal scaring and good healing upon closure with ideal splitting of muscles rather than cutting.

Langer’s lines are certain lines that are present on the dermis and all over the body which indicate the natural orientation of the collagen fibres. Incision made parallel to these lines gives a better healing with minimal scarring.

Langer's lines.


Abdominal and Pelvic incisions –

Vertical incisions – Midline and paramedian.

Transverse and oblique incisions – Kocher’s incision, transverse muscle dividing incision, McBurney’s incision, Oblique muscle cutting incision, Pfannenstiel incision, Maylard’s incision.

Abdominothoracic incisions

Retroperitoneal and extraperitoneal approaches.

Kocher’s incision is modified into two types – Mercedes benz modification and roof top modification (Chevron) incisions


3. McBurney's incision is centered over Gridiron muscle splitting 
8. laterally in order to facilitate access to the ascending colon, this incision is known as the Rutherford-Morison incision. 

Comments

Post a Comment

Popular posts from this blog

CAH - CONGENITAL ADRENAL HYPERPLASIA

-
Image
C   ongenital Adrenal Hyperplasia or CAH, is a disorder which is characterised by defects in enzyme that lead to various effects.  The most common enzyme affected in CAH is 21 hydroxylases enzyme. The second most common enzyme to be affected is 11-β-hydroxylase enzyme. The gene CYP 21A 2 is affected, this is the same gene that codes for 21 hydroxylases. The following image shows the steroid pathway that takes place in the adrenal glands, where cholesterol is the basic material used for synthesis.  Here 21 OH stands for 21 Hydroxylase, 11 beta signifies 11-β-hydroxylase. As the normal physiological process, 21 hydroxylase enzyme acts as an important enzyme for synthesis of corticosteroids and mineralocorticoids. As there is 21 hydroxylase deficiency there will be reduction in the production of corticosteroids and mineralocorticoids. Due to deficiency of mineralocorticoids, there will be salt and water wasting. As the levels of corticoste...
Read more

Neurosurgery - Telovelar approach

-
Image
 Telovelar approach is carried out for the removal of any pathology that is present inside the 4th ventricle or the rhomboid fossa of the brain. The Space seen here behind the cerebellum is the rhomboid fossa (Fossa is just a trench or a channel). This rhomboid fossa forms a part of the 4th ventricle, which is connected to the third ventricle above by cerebral aqueduct and then runs downwards into the spinal cord as the central canal of the spinal cord, carrying the CSF (CerebroSpinal Fluid). The part behind the PONS and between the white core of cerebellum is called as the 4th ventricle. {For more information on anatomy of brain, please refer to our another blog on BRAIN}
Read more

THE BRAIN

-
Image
T he Human brain is by far the most complex structure to be ever build. Its complexity has dazzled majority of the people since last century and is still the topic of research. The adult brain weighs about 1.3 – 1.5 kg and is approximately 2% of or total body weight, with Surface area of approximately 1120 cc in males and 1130 cc in females. In spite of its small size it contains millions and billions of neurons that carry out daily functions of the body and may be create someone like Einstein whose brain is still preserved for research purposes. The basic functional unit of brain is called as a neuron. It is a specialised type of cell that has the capacity to conduct and transfer electrical impulses, but once damaged can take years to regenerate. There are various types of neurons and are classified according to – A)   The number of dendrites/processes B)    The length of axons According to number of processes they are 1.  ...
Read more