Abdominal Paediatric Surgery: Incision Closure Analysis

This section analyzes the options regarding abdominal paediatric surgery, focusing on incision closure techniques.

Option Analysis:

• (a) Transverse abdominal incision is always used
  This statement is incorrect. While transverse incisions (like the Pfannenstiel or rooftop) are common in paediatric abdominal surgery for certain approaches, vertical midline or paramedian incisions are also utilized depending on the surgical condition and access required.
• (b) Incision can be closed with absorbable suture
  This statement is correct. Absorbable sutures (e.g., polyglactin, polydioxanone, monocryl) are frequently used in closing layers of the abdominal wall in paediatric patients. They are suitable for muscle, fascia, and subcutaneous tissues, often eliminating the need for removal and promoting good healing.
• (c) Bowel must be always anastomosed in double layer
  This statement is incorrect. Bowel anastomosis techniques vary. Both single-layer and double-layer closures are performed, often chosen based on surgeon preference, suture material (absorbable or non-absorbable), and the specific clinical situation. Single-layer closures are common in paediatric practice.
• (d) Skin over abdomen can never be closed with subcuticular sutures
  This statement is incorrect. Subcuticular sutures, often using fine absorbable materials, are commonly employed for skin closure in paediatric abdominal surgery to achieve cosmetically acceptable results and avoid suture track marks.

Conclusion:

Based on standard surgical practices in paediatric abdominal surgery, the use of absorbable sutures for incision closure is a valid and common technique.