Early Rehabilitation of Abdominal Muscle Wall Following Lower Transverse Abdominal Incision

Abdominal surgery is a general term used to denote surgical procedures conducted in the abdominal area to detect and treat a presenting medical problem.1 Open Abdominal surgery includes vertical and transverse incisions. Low transverse abdominal incision is usually made 1-2 fingerbreadths above the pubic crest with an incision length of 10-14 cm. The lower transverse abdominal incision is adequate for the vast majority of caesarean operations as well as operative disease of the uterus, fallopian tubes, and ovaries. Historically, the gynaecologist- obstetrician has favoured lower abdominal transverse incisions. Several disadvantages of these incisions exist such as limited exploration of the upper abdomen, greater blood loss as well as they are more susceptible to hematoma formation when compared with a midline incision. Paresthesia of the overlying skin results from nerve injury, is more common in a transverse incision compared with a midline incision.2 With regards to the abdominal muscle, there is a relevant surgical related muscle loss induced by major surgical trauma after lower transverse incisions.3 Early postoperative days are associated with fatigue and limited respiratory movements. For the patient, less post operative pain, rapid return to normal function as well as better scar appearance and quality of life are very important factors. Encouraging early mobilization after low transverse abdominal surgery is crucial for optimal healing and recovery of abdominal muscles. In physical therapy, activities such as, transferring from bed to chair, sitting upright, rising from a chair, exercises in or out of bed and walking in the room are considered helpful for surgical patient.4 Up till now, there is no study searched the effect of starting rehabilitation programs for abdominal muscles very early within the first 24 hours after obstetrics and gynaecology surgeries.