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Skin incision

Authoring team

The skin incision for appendicectomy should be ideally over the point of maximal tenderness. Often, this is McBurney's point and it necessitates McBurney's incision. A Lanz incision is an alternative but there is greater risk of nerve transection with subsequently increased risk of inguinal herniation.

An incision 4-6cm is usually adequate for most appendicectomies - it may be extended according to need.

In adverse circumstances, there are alternatives:

  • presence of peritonitis: right paramedian incision provides better access for peritoneal toilet
  • obese patients: extension of incision with division of rectus medially to gain adequate access
  • incorrect diagnosis:
    • new incision e.g. paramedian
    • extension of incision e.g. to Pfannenstiel

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