Incisions Chapter10 P73-77

Question 1

If a patient has an old incision, is it best to make a subsequent incision next to or through the old incision?
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Answer 1

Through the old incision, or excise the old incision, because it has scar tissue that limits the amount of collaterals that would be needed to heal an incision placed next to it

Question 2

What is used to incise the epidermis?

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Answer 2

Scalpel blade

Question 3

What is used to incise the dermis?

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Answer 3

Scalpel or electrocautery

Question 4

Describe the following incisions:
1. Kocher
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Answer 4

Like a McBurney’s incision except transverse (straight across): (see picture)

Question 5

2. Midline laparotomy

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Answer 5

Incision down the middle of abdomen along and through the linea alba: see picture)

Question 6

3. McBurney’s

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Answer 6

Small, oblique right lower quadrant incision for an appendectomy through McBurney’s point (one third from the anterior superior iliac spine to the umbilicus):
(see picture)

Question 7

4. Rocky-Davis

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Answer 7

Low transverse abdominal incision with retraction of the rectus muscles laterally; most often used for gynecologic
procedures: (see picture)

Question 8

5. Pfannenstiel (“fan-en-steel”)

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Answer 8

Low transverse abdominal incision with retraction of the rectus muscles laterally; most often used for gynecologic
procedures: (see picture)

Question 9

6. Kidney transplant

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Answer 9

Lower quadrant; kidney placed extraperitoneally:

see picture

Question 10

7. Liver transplant

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Answer 10

Chevron or Mercedes-Benz® incision in

the upper abdomen: (see picture)

Question 11

8. Median sternotomy

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Answer 11

Midline sternotomy incision for heart procedures; less painful than a lateral thoracotomy: (See Picture)

Question 12

9. Thoracotomy

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Answer 12

• Usually through the fourth or fifth intercostal space; may be anterior or posterior lateral incisions
• Very painful, but many are performed with muscle sparing (muscle retraction and not muscle transection):
  (see picture)

Question 13

10. CEA (carotid endarterectomy)

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Answer 13

Incision down anterior border of the sternocleidomastoid muscle to expose the carotid: (see picture)

Question 14

11. Inguinal hernia repair (open)

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Answer 14

(see picture)

Question 15

12. Laparoscopic cholecystectomy

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Answer 15

Four trocar incisions: (see picture)