Pfannenstiel incision. A: The Pfannenstiel incision is a horizontal skin incision made just above the symphysis pubis (pubic bone). It is the most popular skin incision made for a cesarean section, and it is also known as the 'bikini cut.' The Pfannenstiel incision was named after Hermann Johann Pfannestiel who lived from 1862 to 1909.
Full Answer
What is a Pfannenstiel incision for cesarean?
A: The Pfannenstiel incision is a horizontal skin incision made just above the symphysis pubis (pubic bone). It is the most popular skin incision made for a cesarean section, and it is also known as the 'bikini cut.'
What is the Pfannenstiel-Kerr technique?
The Pfannenstiel-Kerr technique consists of the Pfannenstiel incision ( Figures 1 – 3 ), which is a transverse skin incision, two fingers above the symphysis pubis, which is extended in the direction of the anterior superior iliac spine (ASIS), and ends 2–3 cm medial to ASIS on both sides [ 8 ].
What is a Pfannenstiel?
Pfannenstiel incision - an incision made transversely and through the external sheath of the recti muscles, about an inch above the pubes. Want to thank TFD for its existence? Tell a friend about us, add a link to this page, or visit the webmaster's page for free fun content . Mentioned in ? References in periodicals archive ?
What is the difference between Staples and closure of Pfannenstiel incisions?
Closure of Pfannenstiel skin incisions. Staples vs. subcuticular suture Pfannenstiel skin incisions closed with subcuticular closure following cesarean section result in less postoperative discomfort and are more cosmetically appealing at the six-week postoperative visit as compared to incisions closed with staples.
What is a Pfannenstiel incision?
A Pfannenstiel incision / ˈfɑːnɪnʃtiːl /, Kerr incision, Pfannenstiel-Kerr incision or pubic incision is a type of abdominal surgical incision that allows access to the abdomen. It is used for gynecologic and orthopedics surgeries, and it is the most common method for performing Caesarian sections today. This incision is also used in Stoppa ...
Why do they use bikini line incisions?
It is often used in preference to other incision types for the sake of aesthetics, because the scar will be hidden by the pubic hair.
What did Kerr say about the uterine incision?
He claimed that it was better than the longitudinal uterine incision in terms of chances for scar rupture and injury to vessels.
Who invented the Kerr incision?
In the United Kingdom, the incision was popularized by Monroe Kerr, who first used it in 1911, so in English-speaking countries it is sometimes called the Kerr incision or the Pfannenstiel–Kerr incision.
Does a belly incision distort the belly button?
The incision does not distort the belly button and heals faster than the traditional vertical incision. The surgeon cuts on a generally horizontal (slightly curved) line just above the pubic symphysis. The skin and subcutaneous fat are lifted off the rectus muscle fascia, going towards the head.
What is the Pfannenstiel incision?
The Pfannenstiel incision, first described by Hermann Johannes Pfannenstiel in the late 19th century, was devised to limit the incidence of incisional hernia that was seen in midline laparotomies. Appendicitis found in an incisional hernia.
Who was the German gynecologist who made the Pfannenstiel incision?
Pfannenstiel, . Hermann Johann, German gynecologist, 1862-1909. Pfannenstiel incision- an incision made transversely and through the external sheath of the recti muscles, about an inch above the pubes. Pfannenstiel transverse approach.
How long can you use a Pfannenstiel catheter?
in Pfannenstiel incision. A single injection can be used, or a catheter inserted for several days for analgesic benefit.
How far above the pubic bone do you make a Pfannenstiel incision?
Make an 8- to 10-cm Pfannenstiel incisionapproximately 3 to 5 cm above the pubic bone, carry the dissection down to the level of the rectus fascia using a combination of electrocautery and blunt dissection, and sweep the fat and subcutaneous tissue clear of the rectus tissue (FIGURE 1, page 26).
What is a PI in surgery?
Surgery A transverse curved abdominal incision with downward convexity, above the symphysis pubis; the PI passes through the skin, superficial fascia, and aponeurosis, and exposes the pyramidalis and rectus muscles, which are separated at the midline, after which the peitoneum is opened vertically Used for Abdominal hysterectomy
What is the procedure for a bladder incision?
In the procedure, the bladder is first instilled with a mixture of normal saline and indigo carmine, and a Pfannenstiel incisionis made into the abdominal cavity.
Where is the incision made in the recti muscles?
an incision made transversely, and through the external sheath of the recti muscles, about 1 inch above the pubes, the muscles being separated at the midline in the direction of their fibers.
What is a Pfannenstiel?
The Pfannenstiel is a transverse lower abdominal incision that is made superior to the pubic ridge. Dissection is made through the skin and subcutaneous fat; the anterior rectus sheath is divided transversely. The rectus muscle is open vertically in the midline sparing the muscle fibers from being divided. The peritoneum is then entered through a vertical incision. This approach is most frequently used for urologic, orthopedic, pelvic, and cesarean sections. The major drawback of this incision is its limited exposure beyond the pelvis. Blood supply to keep in mind is the inferior epigastric branches as well as the superficial epigastric. [10]
Where is the midline incision?
It may be variably sized depending on the type of procedure performed. Midline incisions may be small and applied anywhere on the vertical linea alba. However, they can also extend from the xiphoid process to the pubic bone. This location is mostly avascular plane and does not impose a great risk to the blood supply. There is rarely nerve damage in this region. However, scarring will be present and maybe significant if performing multiple operations through the same incisional scar. This incision generally provides the best visualization and intra-abdominal access and is commonly used for exploratory procedures and traumas. [3]
How to do pleural incision?
This position will expose the abdomen as well as the lateral thoracic region. A vertical incision through the left or right upper quadrant is made to explore the abdominal contents first , and then the incision is extended through the eighth intercostal space from medial to lateral for pleural exposure. The incision will disrupt the rectus abdominis, the oblique muscles, if placed lateral, as well as the transversus abdominis. The thoracic end extends through the intercostals, as well as the latissimus dorsi muscle. Once the thoracic cavity is entered, the lung is deflated. The two incisions should meet at a sharp angle for cleaner closure. The blood supply to the latissimus dorsi is the thoracodorsal artery. This blood supply may be interrupted during the pleural incision laterally. The abdominal incision could lead to disruption in superior epigastric branches. [8]
What is Kocher incision?
The Kocher incision is a subcostal incision on the right side of the abdomen used for open exposure of the gallbladder and biliary tree. This incision is just inferior and parallel to the subcostal margin. Unlike the midline incision, it is not an avascular plane. The incision extends through the anterior rectus fascia, rectus muscle, internal oblique, transverse abdominis, transversalis fascia, and peritoneum. The blood supply of the abdominal wall that is interrupted is the distal aspect of the superior epigastric as well as the inferior epigastric, perforating intercostal arteries, and external oblique perforators. This incision is associated with a slight increase in pain during the post-operative phase due to the severing of the rectus muscle. The incision closure is after the procedure in a layered fashion by suturing and approximating fascial layers. [4]
What is the para median incision?
The para-median incision serves to expose lateral viscera. It is made 3cm, on average, lateral to the midline. The skin and subcutaneous tissue must be incised, the anterior rectus sheath, and the rectus muscle is deflected laterally if possible to expose the posterior rectus sheath if above the arcuate line. Upon passing the rectus is entry to the peritoneum. Peripheral branches of the inferior epigastric will undergo ligation. [5]
What is the incision made transversely through the skin and subcutaneous tissues inferior to the clavicle?
However, if access to the distal subclavian artery is needed, then a supraclavicular incision may be utilized. [12]
Where is the transverse incision made?
A transverse incision 6cm above the pubic tubercle is made through the rectus abdominis to gain access to pelvic structures. The incision is made through the rectus abdominis on both sides, through the linea alba, and the medial aspects of the obliques. The portions of the inferior epigastric, as well as the superficial epigastric, will be damaged. [20]
Why is it important to choose an incision?
An intelligent choice of incision depends on a thorough understanding of the anatomy of the abdominal wall. Not only does this permit the surgeon to avoid injury to nerves and blood vessels, but it also minimizes the chance of dehiscence and promotes effective healing.
Is abdominal wall vascular deficiency a complication of abdominal wall surgery?
Because of their rich anastomoses, vascular deficiency is usually not a complication of abdominal wall surgery.
What is the difference between Misgav Ladach and Pfannenstiel-Kerr?
The Misgav Ladach technique is claimed to have several advantages compared with the Pfannenstiel-Kerr technique. Major differences are digital manual manipulation instead of using sharp instruments which is associated with the least possible trauma to the tissues, less blood loss, faster recovery, shorter anaesthetic time, and using less suture material [ 16 ]. A reduced level of antibiotic and narcotic use, fast er return of normal bowel function, shorter maternal hospital stay and less postoperative adhesion formation as well as lower incidence of fever, and urinary tract infection has been suggested for that technique. The Misgav Ladach technique is suitable for both elective and emergency caesarean section [ 17 ].
What happens to the skin after a cesarean section?
The skin is being closed following the cesarean section.
How is Joel Cohen technique performed?
In the Joel-Cohen technique, the skin incision is placed 3 cm above the original Pfannenstiel incision, the subcutaneous tissue is incised only in the three most medial centimetres, and the lateral tissue is separated manually, before the fascia is divided bluntly with both index fingers inserted in the deep fascial space created by the knife. Then, the peritoneum is opened bluntly with fingers, the uterine cavity is incised, and the incision is extended bluntly laterally by two fingers [ 9 ]. The placenta is delivered spontaneously, after delivery of the baby [ 10 ]. The uterine closure is made by a single interrupted layer, the peritoneal closure is omitted, and the fascial closure is also interrupted. The subcutaneous suture is omitted, and the skin is sutured continuously ( Figures 4 and 5 ). The Joel-Cohen technique is claimed to be faster to perform, causes less blood loss, less postoperative pain, shorter hospital stay, less postoperative infection, is more economic, and saves more staff time, and utilises less anaesthesia in comparison with the Pfannenstiel-Kerr technique [ 11 ].
Why is the peritoneum closed after laparotomy?
Possible advantages of closing the peritoneum after caesarean section include restoration of anatomy, reduction of infection, reduction of wound dehiscence, reducing haemorrhage, and a minimisation of adhesions [ 59 ], whereas the suturing of the peritoneum may cause peritoneal tissue ischaemia at the edges, which may delay healing and serve as a cause of intraperitoneal adhesions and febrile morbidity.
