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July 1929


Arch Surg. 1929;19(1):129-142. doi:10.1001/archsurg.1929.01150010132004

The type of incision employed is one of the most important factors in the ultimate results obtained in operations on the abdomen. Sir Barkley Moynihan, in his chapter on abdominal incisions, stated that if the incision is improperly made by the free division of muscular fibers or a wilful and unnecessary severing of nerve trunks a weakened area is left in the abdominal wall, which may cause the patient distress of even greater severity than did the condition which primarily necessitated the operation. It would seem that the qualifications which should commend an abdominal incision are: that it give adequate exposure, disturb a minimum number of nerve and muscular fibers and be so placed that closure is simple, and that a minimum number of postoperative hernias follow its use.

I feel that there have been too many postoperative hernias following midline incisions or long incisions of the right rectus muscle