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Article
November 17, 1917

THE RECTANGULAR FLAP INCISION FOR OPERATIONS WITHIN THE UPPER ABDOMEN

Author Affiliations

Attending Surgeon, German and Postgraduate Hospitals NEW YORK

JAMA. 1917;LXIX(20):1677-1684. doi:10.1001/jama.1917.02590470017006
Abstract

The last decades have witnessed an increasing tendency of operative surgery to emancipation from the time-honored rule of placing the skin incision parallel to the longitudinal axis of the body.

Trendelenburg's transverse incision for operations within the bladder (1882) was one of the forerunners in this direction.1 Later followed Pfannenstiel's2 suprasymphyseal transverse incision of skin and fascia with median division of the deeper tissues for operations on the uterus and its adnexa (1898). In 1910, Sprengel3 of Brunswick demonstrated the advantages of the transverse direction of the incision in abdominal operations. He emphasized that the broad aponeurotic expansions of the three flat abdominal muscles which join and interlace with those of the opposite side in the median line, forming the linea alba, represent the tendinous termination of these muscles. If the latter contract, the many fine, little, tendonlike fascicles and fibers of these aponeuroses are put on

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