Knowledge anatomy is essential to avoid or secure major vessels to enhance appropriate repair, so as to reduce the risk of incisional or

wound dehiscence

Category of incision

MidlineTransverse

Transverse Incisions

Maylard incisionPfannenstiel IncisionCherney incisionKustner incision

Maylard’s Incision

Made 2 fingerbreadths above the symphysis pubis (appr. 3-4 cm)

Carried down through the subcutaneous fat and through Scarpa’s fascia

Transverse Incisions; Maylard Fascia overlying the abdominal

wall muscles is identified

Scarpa’s fascia covers the sheath of the rectus

Rectus muscle now could be seen clearly

Lower portion of the rectus sheath is dissected from rectus belly

Pfannenstiel Incision

Cherney Incision

The incision affords less exposure than the Pfannenstiel and almost no extensibility.

Median Incision

Midline Incision

Advantages 1.It is almost bloodless2.No muscle fibres are divided3.No nerves are injured4.Good access to the upper abdominal viscera5.It is very quick to make as well as to close6.A midline epigastric incision also can be extended the full length of the abdomen curving around the umbilical scar

Closing the abdomen

Caesarean Section