The Pfannenstiel incision is a type of surgical incision made in the lower abdomen. It is used primarily in women during childbirth through the abdomen, also known as cesarean section. This incision can also be used to perform surgery on organs of the female reproductive system.
First reported in 1900 by German gynecologist Hermann Johannes Pfannenstiel, the Pfannenstiel incision was used for gynecological surgery on women. The incision was developed to avoid hernias or bulges in the abdominal wall that can occur after surgery. It is cosmetically pleasing as well, since the scar is hidden within folds of skin on the abdomen. Often referred to as the “bikini cut,” the Pfannenstiel incision is popular because it is done low on the abdomen and the patient can still comfortably wear a bikini without evidence of a scar.
The Pfannenstiel incision is a slightly curved horizontal incision about 0.8 to 1.1 inches (2-3 cm) above the pubic bone, also known as the symphysis pubis. This incision is usually about 4.7 to 5.9 inches (12-15 cm) in length. After making the incision, the surgeon peels away the layer of fat and tissue beneath the skin.
Rectus muscles of the abdomen must be pushed to each side in order to cut the peritoneum and enter the abdomen. After the surgical procedure is complete, the surgeon closes the muscles and fascia with sutures. The incision in the skin of the lower abdomen is usually closed with staples that are removed within three to four days.
If the patient needs major surgery involving the use of the Pfannenstiel incision, a general anesthetic would likely be used and the patient would be asleep. During a cesarean birth, a surgeon would probably use a regional anesthetic injected into either the cerebrospinal fluid in the lower spine or in the epidural area surrounding the spine. This would allow the patient to remain awake and assist in childbirth, while not experiencing any pain.
Patients will probably spend three to four days in the hospital after abdominal surgery. The incision may be painful, but the pain should diminish each day. Pain management should be discussed with the physician.
Recovery from the surgery and the Pfannenstiel incision could take a few weeks. Patients should watch for any swelling, infection or bleeding from the incision and report these side effects to the physician. The patient should arrange to have help at home and should avoid heavy lifting or anything that would put pressure on the incision.