Which of the following is the preferred incision in a patient with suspected abdominal injury due to blunt trauma?
|C||Incision at the site of injury|
a. All abdominal explorations in adults are performed using a long midline incision because of its versatility.
b. For children under the age of 6, a transverse incision may be advantageous
c. The incision should be made with a scalpel rather than with an electrosurgical unit because it is faster. Liquid and clotted blood is rapidly evacuated with multiple laparotomy pads and suction. Additional pads are then placed in each quadrant to localize hemorrhage, and the aorta is palpated to estimate blood pressure.
d. If exsanguinating hemorrhage is encountered upon opening the abdomen, it is usually caused by injury to the liver, aorta, inferior vena cava, or iliac vessels. If the liver is the source, the hepatic pedicle should be immediately clamped (a Pringle maneuver) and the liver compressed posteriorly by tightly packing several laparotomy pads between the hepatic injury and the underside of the right anterior chest wall. This combination of maneuvers will temporarily control the hemorrhage from virtually all survivable hepatic injuries.