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A Pfannenstiel incision is a horizontal, curved surgical incision made just above the pubic bone, typically along the bikini line. This incision is commonly used in gynecological surgeries, such as cesarean sections, hysterectomies, and surgeries involving the bladder or pelvis. The Pfannenstiel incision is favored because it provides good access to the pelvic organs while minimizing visible scarring and promoting better cosmetic outcomes. The incision usually measures around 10 to 15 centimeters and involves cutting through the skin, subcutaneous tissue, and fascia, while the underlying muscles are separated, not cut, to reduce trauma and enhance recovery. The primary reasons for using a Pfannenstiel incision are to perform abdominal surgeries where access to the pelvic organs is required, such as in childbirth via cesarean section, removal of the uterus (hysterectomy), or surgeries related to ovarian cysts, fibroids, or bladder issues. It is chosen over vertical incisions when a less invasive, cosmetically preferable approach is desired. Complications associated with the Pfannenstiel incision include the standard risks of surgery, such as infection, bleeding, or poor wound healing. In some cases, there may be a risk of developing a hernia at the incision site, though this risk is lower compared to vertical incisions. Numbness or pain around the incision site can occur due to nerve damage. Additionally, the cosmetic outcome might not always be ideal, depending on the patient's healing process or complications like keloid formation. Despite these risks, the Pfannenstiel incision is widely regarded as a safe and effective surgical approach.
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