SURGICAL INCISIONS

BWALYA MUNJILI
(Msc. Nsg, Bsc. Nsg, RoTN, RN)

MUNJILI 1
SURGICAL INCISIONS
 INTRODUCTION
• In surgery, a surgical incision is a cut made through the skin to
facilitate an operation or procedure
• Often, multiple incisions are possible for an operation
• In general, a surgical incision is made as small and unobtrusive
as possible to facilitate safe and timely operating conditions.
 TYPES OF INCISIONS
Head and neck
• Wilde's incision - This post-aural incision
is used for a variant mastoiditis drainage,
and was named after Sir William Wilde,
an ENT surgeon in Dublin who first
described it at the end of the nineteenth
century
• It is used in mastoidectomy
 The Chest
• Median sternotomy - This is the primary incision used for
cardiac procedures
• It extends from the sternal notch to the xiphoid process
• The sternum is divided, and a finochietto retractor is used to
keep the incision open
• Thoracotomy - A division of the ribs from the side of the chest.
 Abdomen and pelvis

• Midline incision or midline laparotomy - The

most common incision for laparotomy is the
midline incision, a vertical incision which follows
the linea alba
• Midline incisions are particularly favoured in
diagnostic laparotomy, as they allow wide access
to most of the abdominal cavity
 …………
–The upper midline incision usually extends from
the xiphoid process to the umbilicus
–A typical lower midline incision is limited by the
umbilicus superiorly and by the pubic symphysis
inferiorly
Midline incision
 ………….
• Sometimes a single incision extending from
xiphoid process to pubic symphysis is employed,
especially in trauma surgery
• Typically, a smooth curve is made around the
umbilicus.
 Paramedian Incision
• It is about 2- 5cm to the left or right of the midline
incision, known as either Left Paramedian or
Right Paramedian
• Incision is over the medial aspect of the transverse
convexity of the rectus muscle
• It allows access to the kidney, adrenals and spleen
Right paramedian incision
 Gridiron's incision (Mc Burney's incision)
• Described in 1894 by McBurney
• An oblique incision made in the right lower quadrant of the
abdomen, classically used for appendectomy
• It is two thirds from the umbilicus and a third from the right
anterior superior iliac spine.
• The incision is oblique beginning laterally from above and
ending medially.
 Lanz Incision
• The incision can be made transverse
and placed in a skin crease
• This is called transverse Lanz incision
as this is more aesthetically pleasing
and the scar is hidden in the bikini
line
• It also used for appendictomy
Mc Burney’s and Lanz incisions
 Pfannenstiel incision
• In the Pfannenstiel incision, a transverse incision below the
umbilicus and just above the pubic symphysis
• In the classic Pfannenstiel incision, the skin and subcutaneous
tissue are incised transversally, but the linea alba is opened
vertically
• It is the incision of choice for Caesarean section and for
abdominal hysterectomy for benign disease.
Pfannenstiel incision
 Kocher’s incision/Subcostal incision
• An oblique incision made in the right upper
quadrant of the abdomen, classially used for open
cholecystectomy
• Named after Emil Theodor Kocher
• It is appropriate for certain operations on the liver,
gallbladder and biliary tract
 …………..
• It starts in the midline, 2-5 cm below the xiphoid,
extending in parallel with the costal margin at
about 2.5 cm below the costal margin
 ………..
• This shares a name with the Kocher incision used
for thyroid surgery (thyroidectomy): a transverse,
slightly curved incision about 2 cm above the
sternoclavicular joints
Kocher’s/Subcostal incision
ANY QUESTION?
THE END