Scars

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Author:
Anonymous
ID:
299413
Filename:
Scars
Updated:
2015-03-29 12:11:51
Tags:
scars osces stage1
Folders:
osces
Description:
Scars
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    • Midline sternotomy
    • CABG (look for scar from vein
    • harvesting on leg/arm/could be internal thoracic arteries)
    • Valve
    • Aortic dissection
    • Transplant
    • Congenital cardiac defect corrections
  1. Axillary thoracotomy
    • A bit higher than posterolateral thoracotomy
    • Muscle sparing
    • Pneumothorax
    • Pulmonary resections (pneumo/lobectomy, wedge)
    • Pleurectomy
    • Posterolateral thoracotomy
    • Pulmonary resections: Pneumonectomy, Lobectomy, wedge
    • Oesophagus
    • Heart/aorta
    • Chest wall resection
    • Anterolateral thoracotomy
    • MVR/mitral valvotomy
    • Coarctation repair
    • Lobectomy
    • Oesophagectomy if rooftop
    • also present
    • Left: open chest massage
    • Subclavicular scar
    • Pacemaker
    • Lanz scar
    • Appendicectomy
    • More transverse, medial, closert to ASIS than McBurney's - can be hidden in a skin crease
    • McBurney's scar
    • Appendix
    • At McBurney's point (2/3 to ASIS from umbilicus), perpendicular to this line
    • 1. Kocher
    • 2. Midline
    • 3. McBurney
    • 4. Battle incision (appendicectomies - rare)
    • 5. Lanz
    • 6. Paramedian
    • 7. Transverse incision
    • 8. Rutherford Morrison
    • 9. Pfannenstiel
  2. When to perform a transverse incision
    • In children/neonates - lack of diaphragmatic and pelvic recesses (difficult in adults because of subdiaphragmatic and pelvic structure)
    • Quick healing, fewer respiratory complications than midline, less pain
    • Pfannenstiel
    • C section (and other gynae)
    • Lower GI/UT
    • Hernias (esp. bilateral)
    • Prostate
    • Kocher's scar
    • Cholecystectomy
    • Liver/gall bladder/biliary tract
    • Rutherford Morrison scar
    • Kidney transplant
    • Colonic resection / caecostomy (R) / sigmoid colostomy (L)
    • 'Mercedez benz' - bilateral rooftop with sternal extension
    • Diaphragmatic hernias
    • Rooftop indications
  3. Rooftop indications
    • aka Chevron
    • Gastrectomy
    • Oesophagectomy
    • Bilateral adrenalectomy
    • Liver resections
    • Liver transplant
    • Kidneys
    • Midline laparotomy
    • Most abdominal operations
  4. Paramedian indications
    extension?
    • Spleen
    • Kidney
    • Adrenal
    • Mayo-Robson scar: paramedian incision, curved towards xiphoid process - allows bigger opening

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