Surgical Incisions Summary

  • Definition of Surgical Incisions: A cut made through the skin to facilitate an operation; surgeons aim to use the most suitable type for each procedure.

  • Importance for Nurses:

    • Circulating Nurse: Must know the extent and area to be prepared and gather necessary equipment for patient positioning.
    • Scrub Nurse: Must guide draping the operative site, ensure correct instruments and supplies are available, and assist the surgeon effectively.

  • Abdominal Layers:

    1. Skin
    2. Subcutaneous Tissue
    3. Fascia
    4. Muscle
    5. Peritoneum

  • Cesarean Section Incision Structure:

    • Layers include skin, subcutaneous tissue, fascia, muscles, and peritoneum.

  • Regions of Abdominal Area:

    • Right Hypochondriac: Liver, gallbladder
    • Epigastric: Esophagus, stomach
    • Left Hypochondriac: Stomach, pancreas, spleen
    • Right Lumbar: Kidney, colon
    • Umbilical: Colon, intestines
    • Left Lumbar: Kidney, colon
    • Right Iliac: Appendix
    • Hypogastric: Bladder, uterus
    • Left Iliac: Sigmoid colon.

  • Types of Abdominal Incisions:

    • Paramedian: Lateral to midline for quick abdominal entry.
    • Longitudinal Midline: Vertical from xiphoid to suprapubic.
    • Subcostal (Kocher's): Lateral below costal margin, used for gallbladder exposure.
    • Chevron: Bilateral for visibility, often used in liver operations.
    • McBurney's: Oblique in right lower quadrant, for appendectomy.
    • Pfannenstiel (Bikini): Curved, used in hysterectomy and cesarean sections.

  • Other Incision Types:

    • Thoracotomy: Anterolateral and posterolateral for lung and heart operations.
    • Collar (curvilinear): For thyroid surgery.
    • Elliptical (Halsted): Radical mastectomy.
    • Limbal: For cataract extractions.