Surgical Incisions: What You Need To Know

How Incisions Are Made, Types of Incisions and Care of Incisions

Mature surgeon using scalpel during surgery
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An incision is a cut made into the tissues of the body to expose the underlying tissue, bone or organ so that a surgical procedure can be performed. An incision is typically made with a sharp instrument, such as a scalpel, that is extremely sharp and leaves the skin and tissues with clean edges that are able to heal well.  

It is a common misunderstanding that an incision cuts through the skin when in fact it typically goes through the skin, the underlying tissue, and often through muscle in order to allow the surgeon to access the surgical site.  For this reason, an incision may appear to have healed on the surface in only a week or two but can take months to reach full strength as the underlying muscle and tissues continue to heal. 

Incision Size

A traditional "open" incision is a large incision used to perform surgery. An open incision is typically at least three inches long but may be much larger. This allows the surgeon enough room to work and see the area that is being worked on and to insert the necessary surgical instruments to perform surgery.  An incision may be enlarged during surgery in order to give the surgeon more room to work.  For example, when a patient is having gallbladder surgery, a small incision may initially be made.  If the surgeon discovers that the gallbladder is very large and full of gallstones, the incision may be made larger so that it is large enough for the gallbladder to be removed.

Surgical incisions, in general, are getting much smaller.  Laparoscopic, or minimally invasive (keyhole) incisions, are much smaller than the traditional open incision and are just large enough allow surgical instruments to be inserted into the body.  Instead of having one incision that is four inches long, you may have three or four that are less than an inch long.  For abdominal surgeries, one of these is often hidden in the belly button, so scarring is minimized. 

Care of Incisions

Incisions require tender loving care, not harsh scrubbing and strength testing.  Be gentle on your incision, don't push your incision to its limits as they can and do open when too much stress is applied.  Don't scrub your incision, scabs on will form on your sutures and they are supposed to be there, it is a sign of healing.  Use gentle soap and water in the shower and rinse thoroughly. If you were given dressing change instructions, be sure to follow them.

If you notice your incision starting to form a gap, let your surgeon know, as it should be healing along the entire incision, not just in random places.  A gap in your incision is an easy way for infection to begin.

Also Known As: incisions

Examples: The typical incision for an appendectomy used to be four to five inches in length, now, with minimally invasive techniques, there are several incisions less than an inch in length.

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