The lateral paramedian incision--experience with 850 cases.

We present our experience in 850 consecutive patients who had a laparotomy through a lateral paramedian incision during the period 1977-1981. These patients underwent both elective and emergency procedures covering a wide range of intra-abdominal conditions, and had a high incidence of factors known to predispose to wound dehiscence and incisional hernia formation. Follow-up in each case for at least 1 year revealed no wound dehiscences and 3 incisional hernias (0.37 per cent). We conclude that the lateral paramedian incision is inherently strong and that this strength is due to the splintage of the wound by the rectus abdominis muscle and the wide shutter mechanism that this provides.