First, the classification of wounds The height of the transverse wound is about 3 or 4 cm above the pubic symphysis, and the length of the wound is about 10- 15 cm. The skin, subcutaneous tissue and fascia are all transected, but when they reach the rectus abdominis, they are cut longitudinally at the midline and enter the abdominal cavity.
The longitudinal cut wound is located between the navel and pubic symphysis, and the length of the wound is about 15 cm.
Cross-cutting and vertical cutting are only a matter of surgical incision selection. Crosscutting is a surgical method initiated by Israelis, which is mainly beneficial to extubation early after operation, and the pressure on incision due to gravity is less. Regardless of transverse cutting or vertical cutting, it is emphasized that the second pregnancy must be three years later, otherwise uterine rupture will easily occur.
Uterine wall incision can be divided into three types.
1. Longitudinal incision of upper uterus: This is a traditional caesarean section.
2. Longitudinal cutting of the lower part of uterus.
3. Transverse cutting of the lower part of uterus.
At present, the third method is the most common and safest, and the first and second methods are only used in emergencies.
Second, the advantages of transverse injury of the lower uterine segment
The transverse wound of the lower part of uterus is about 10 cm. After the water is broken, the fetus is delivered, and then the myometrium is sutured by two-layer suture method, and the third layer is sutured back to the peritoneum. The advantages of this method include:
1, reducing the chance of peritonitis or abdominal adhesion.
2. The muscle layer here is thin and there is little bleeding.
3. The incision here is not within the strong contraction range of uterine delivery, so the chance of wound rupture is small.
Third, related knowledge
Incision sequence of caesarean section
The so-called laparotomy does not mean that the fetus can be taken out through a single incision. According to the operating instructions of laparotomy in Taian Hospital, the mode of laparotomy is to cut a wound about 15 cm in the lower abdomen of pregnant mommy, then cut subcutaneous fat, muscle membrane, abdominal muscle, peritoneal layer and uterine muscle layer in turn, and finally cut the amniotic fluid cavity, and then deliver the fetus. After taking out the placenta, sew the above layers in turn, and finally sew the abdominal skin with absorbable thin lines.
Appearance of abdominal wound
The laparotomy wound that many mothers care about refers to the first incision made by the doctor. Dr Chen Fangyi said that there are usually two ways to cut the abdomen: horizontal cutting and straight cutting. The wound left by crosscutting will be more beautiful, located in the lower abdomen, probably the pubic hairline. This position is not obvious, so mommy can still wear it naked after giving birth. At present, the abdomen is usually cut like this.
The advantage of direct cutting is that it is simple and fast, and it is faster to enter the uterus and take out the baby after cutting. This method is usually used in an emergency, but relatively speaking, its disadvantage is that the wound is larger and the scar will be more obvious.
The last knife in hysterectomy is to cut the uterus. Dr. Chen Fangyi says there are four ways to remove the uterus:
1. Classic.
2.t-shape method.
3. The lower segment is low vertical.
4. Low transverse, Dr. Chen Fangyi said that at present, the general practice is to adopt the method of low transverse uterus.
Anesthesia: Dr. Chen Fangyi said, generally speaking, at present, caesarean section mostly adopts half-length anesthesia, and the anesthesiologist decides the anesthesia method and implements it, because the risk of half-length anesthesia to mommy is low, and the anesthetic will not affect the fetus through the placenta. General anesthesia can only be performed under some special circumstances, such as infection in the anesthesia site of the lower body, mommy's blood coagulation problems, or mommy's extreme fear of caesarean section when she is awake.