title: Circumferential cutaneous traction for exposure of the layers of the abdominal wall.
abstract: BACKGROUND
  Clear exposure of the operative field at all stages of a surgical procedure is a requirement of an optimal intervention. Current techniques for retraction do not provide visualization of the abdominal wall.
  
  
  METHODS
  A new method for elevation of the abdominal wall to expose all 5 layers of this structure was devised. This involved circumferential skin traction on a fixed retractor using heavy monofilament structures.
  
  
  RESULTS
  This new technique allowed entrance into the abdominal cavity in patients having reoperative surgery with less damage to small and large bowel loops immediately beneath the abdominal incision. Tumor masses recurring within a midline abdominal incision were excised with margins well visualized.
  
  
  CONCLUSIONS
  Circumferential cutaneous traction allows strong anterior traction that spreads out the layers of the abdominal wall to expose these structures more adequately.
authors.affiliation: Washington Cancer Institute, Washington Hospital Center, Washington, DC 20010, USA. paul.sugarbaker@medstar.net
authors.forename: Paul H
authors.initials: PH
authors.lastname: Sugarbaker
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D006801:Humans; D013525:Surgical Instruments