Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . hat the nerves are not parallel with the fibres of the externaloblique but run somewhat more transversely. Incisions through the skinmay be made as long as desired and in any direction without regard to thenerves. The same may be said of the fascia lying on the muscles. Median incisions are used for parts most easily available thereby. Abovethe umbilicus they are used to expose the stomach, liver, pancreas and in-testines. They should be made preferably through th
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . hat the nerves are not parallel with the fibres of the externaloblique but run somewhat more transversely. Incisions through the skinmay be made as long as desired and in any direction without regard to thenerves. The same may be said of the fascia lying on the muscles. Median incisions are used for parts most easily available thereby. Abovethe umbilicus they are used to expose the stomach, liver, pancreas and in-testines. They should be made preferably through the fascia external tothe inner edge of the rectus. Lateral vertical incisions along the outer border of the rectus are so aptto damage the motor supply of the rectus as to be decidedly are used for the gall-bladder, bile ducts, liver, duodenum, spleen, kid-neys, ascending and descending colon. Lateral muscle-splitting incisions are made by separating the fibres ofmuscles, one after another, identifying and protecting the nerves especiallybetween the transversalis and internal oblique, and holding the muscles. Fig. i 182.—Transverse Superficial and Vertical Deep Incisions. The rectus muscle is drawn inward, the oblique and transversalis muscles are split and retracted, and the transversalis fascia and peritoneum are incised vertically. apart while the transversalis fascia and peritoneum are incised and the opera-tion performed. They are used to expose the lateral parts of the abdomen. Transverse incisions combine the above. Usually they are transversethrough the skin and superficial fascia only. Such incisions are used insome instances to obviate the vertical scar. For cosmetic purposes it ispossible to place the incision largely within the area of the pubic hair. Itmay also be placed in the transverse suprapubic crease which is present inthe fat abdomen. The incision is carried through the skin and fascia downto the superficial layer of the deep fascia lying
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
