Abdomen Incisions and the Surgical Wound

Question 1

vertical, skirting around left edge of umbilicus .
incised in line with the linea alba through the subcutaneous fascia, linea alba, transversalis fascia and parietal peritoneaum
wide incision superior to umbilicus and more thin below

Answer 1

midline incision

Question 2

incision 2.5 to 4 cm lateral and parallel to the midline, the anterior rectus sheath is opened, rectus muscle displaced laterally, then posterior sheath, peritoneum are both incised

Answer 2

paramedian incision

Question 3

transverse incision is made in the suprapubic skin crease roughly 5cm above the pubic symphysis, about 12cm long, lies below arcuate line.
through skin, subcutaneous fascia, rectus abdomens muscle split along linea alba
in emergency skin and rectus abdomens incised transverse plan

Answer 3

pfannenstiel incision

Question 4

Incision used for gallbladder, biliary system, pancreas, liver, adrenal gland, portal system

Answer 4

Right subcostal (kocher)

Question 5

Oblique skin incision made over McBurney’s point in right lower Quadrant. Muscle-splitting incision

Answer 5

McBurney incision

Question 6

Curved skin incision, which breaches both pleural and abdominal cavities. Continues through rectus abdominus, external oblilque, serratus anterior and intercostal muscles.

Answer 6

Thoracoabdominal incision

Question 7

Oblique skin incison made 2-5 cm superior and parallel to inguinal crease. Muscle splitting incision; AKA: Lower oblique incision or groin incision

Answer 7

Inguinal incision

Question 8

muscles involved from outside in

Answer 8

rectus abdominus, internal oblique, transverse abdominus

Question 9

(Through the fold of umbilicus - commonly used in laparoscopic surgery)

Answer 9

umbilical

Question 10

used for open heart procedures

Answer 10

median sternotomy

Question 11

incision made under ideal surgical conditions, no break in sterile technique during procedure, primary closure, no wound drain, no entry to aerodigestive or genitourinary tract

Answer 11

Class I: Clean

Question 12

Primary closure, wound drained, minor break in sterile technique occurred, controlled entry to aerodigestive (includes biliary) or genitourinary tract

Answer 12

Class II: Clean Contaminated

Question 13

open traumatic wound less than 4 hours old, major break in sterile technique occurred, acute inflammation present, entry to aerodigestive or genitourinary tract with spillage

Answer 13

Class III: Contaminated

Question 14

Open traumatic wound more than 4 hours old, microbial contamination prior to procedure, perforated viscus (bowel)

Answer 14

Class IV: Dirty/Infected

Question 15

When is the final wound classification assigned

Answer 15

assigned at the end of the procedure

Question 16

removal of devitalized tissue and contaminants

Answer 16

debridement

Question 17

irrigation/incision and debridement

Answer 17

I&D

Question 18

Abrasion

Answer 18

scrape

Question 19

Contusion

Answer 19

bruise

Question 20

laceration

Answer 20

cut or tear

Question 21

5 signs of inflammation

Answer 21

pain, heat, redness, swelling, loss of function

Question 22

three types of wound healing

Answer 22

first intention, second intention, and third intention

Question 23

healing occurs from side to side in a sterile wound in which dead space has been eliminated; wound tensile strength plateaus at the 3rd month at 70 to 80%

Answer 23

First Intention or Primary Union

Question 24

occurs when a wound fails to heal by primary union; the wound is left open an allowed to heal from the inner layer to the outside surface

Answer 24

Second intention or granulation

Question 25

occurs when two granulated surfaces are approximated; the traumatic surgical wound is debrided and left to heal by second intention for 4 to 6 days and then closed and allowed to heal through primary closure

Answer 25

third intention or delayed primary closure

Question 26

the partial or total separation of a layer or layers of tissue after closure

Answer 26

Dehiscence

Question 27

exposure of the viscera through the edges of a totally separated wound; emergency situation

Answer 27

evisceration

Question 28

a separation of internal wound layers that have not been closely approximated, or air that has become trapped between tissue layers

Answer 28

Dead space

Question 29

3 Phases of wound healing - First Intention/No infection

Answer 29

Inflammatory (lag) phase
Fibroplasic ( proliferative) phase
Remodeling (maturation) phase

Question 30

Opening or passageway between two organs that normally do not connect

Answer 30

Fistula

Question 31

Excessive (hypertrophic) scar formation

Answer 31

Keloid Scarring

Question 32

Protrusion of an organ or tissue from cavity where it is normally found

Answer 32

Herniation

Question 33

What medicines inhibit wound healing?

Answer 33

Steroids decrease inflammation and respirations slow, vitamin A counterreacts these effects

Question 34

What kind of drainage is sanguineous?

Answer 34

bloody

Question 35

What kind of drainage is serous?

Answer 35

Clear drainage

Question 36

Identify
This is a passive drain, which can be used to create a conduit for drainage.

Answer 36

Penrose Drain

Question 37

Identify
Passive drain that consists of a round collection reservoir with three springs inside. Usually used when expecting a large amount of drainage.

Answer 37

Hemovac

Question 38

Drainage system that has a small bulb reservoir. Commonly referred to as a JP Drain

Answer 38

Jackson-Pratt Drain