Gynecology . Fig. 373.—The Pfannenstiel fascia has been cut transversely and is being stripped back from the rectus muscles. The attach-ment at the linea alba is trimmed away with scissors (after Doderlein-Kronig). In addition to the cosmetic value of the incision, other advantages areclaimed for it. Postoperative hernia is supposed to be less common followingit. Patients are able to get up earlier during convalescence and do not requireabdominal binders. On the other hand, it has the important disadvantage ofhaving considerably greater tendency than the longitudinal wound to beco
Gynecology . Fig. 373.—The Pfannenstiel fascia has been cut transversely and is being stripped back from the rectus muscles. The attach-ment at the linea alba is trimmed away with scissors (after Doderlein-Kronig). In addition to the cosmetic value of the incision, other advantages areclaimed for it. Postoperative hernia is supposed to be less common followingit. Patients are able to get up earlier during convalescence and do not requireabdominal binders. On the other hand, it has the important disadvantage ofhaving considerably greater tendency than the longitudinal wound to becomeinfected. It also requires more time during the operation, both in making andin closing it. OPERATIONS ON THE ABDOMINAL WALL 669. Fig. 374.—The Pfannenstiel fascia has been stripped back from the rectus muscles above and below. The rectusmuscles have been separated in the middle line and the peritoneum is being opened longitudinally(after Doderlein-Kronig). DIASTASIS OF THE RECTUS MUSCLES In order to determine the extent of the diastasis of the rectus muscles duringa pelvic operation the left hand is placed in the wound, palm up, with the middlefinger at the umbilicus. By lifting up the abdominal wall with the hand in thisposition the thinned-out central portion of the wall becomes apparent, whilethe edges of the separated rectus muscles can be readily felt. In most cases of abdominal relaxation the abnormal separation of the musclesextends above the umbilicus. When the pelvic operation has been finished theskin incision is enlarged to about 2 inches above the umbilicus. The incisionis not carried deeper than the fat. The skin and fat layer is then dissectedwidely away from the aponeurosis (the at
Size: 1648px × 1517px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdec, booksubjectgynecology, booksubjectwomen
