LEARNING  OBJECTIVES
     To understand
       The  principles  of  skin and  abdominal incisions
       The  principles of  wound closure
       To   know  the  principles  in  performing:
       Bowel  anastomoses
       Vascular  anastomoses
      To be aware of:
       The  principles of  drain  usage , diathermy, ligasure 
        and  harmonic  scalpel
                          Basic surgical skill & anastomosis                             
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     INCISIONS
                         Basic surgical skill & anastomosis                             
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    Factors  considered  when  
    planning    askin  incision
     1) Skin  tension  lines (Langer s  lines)
                         Basic surgical skill & anastomosis                             
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    Anatomical  structure
       Incision  should  be  avoid  bony  prominences, 
        and  crossing  skin  creases  if  possible, and 
        take  care  of  underlying  structures , such  as  
        nerves  and  vessels.
      Cosmetic  factors. 
      Adequate  access  for  the 
        procedure.
                         Basic surgical skill & anastomosis                             
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      Abdominal  incisions
       As for skin incisions, all abdominal incision  
        should be planned in advance of surgery 
        and taking into consideration access to  the 
        abdominal organs ,surface anatomy, pain 
        control and cosmetic outcome .
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