Sutures and Wound Repair/ General Surgery (ABSA) Practice Test

Which of the following must be sutured to close an upper paramedic incision?

1. Anterior rectus sheath

2. Rectus abdominal muscle

3. Posterior rectus sheath

4. Peritoneum

The correct answer is: Anterior rectus sheath

In the context of closing an upper paramedic incision, suturing the anterior rectus sheath is crucial for several reasons. The anterior rectus sheath is the layer that covers and protects the rectus abdominal muscles, and it plays a vital role in providing stability to the abdominal wall. When closing an incision in this area, it is essential to reapproximate all layers to restore the integrity of the abdominal wall and minimize complications such as herniation. By suturing the anterior rectus sheath, the closure provides a tensile strength and allows for proper wound healing. This layer helps distribute the mechanical forces across the abdominal wall, which is particularly important in preventing the development of bulges or weakness at the incision site. While other structures, such as the rectus abdominal muscle, posterior rectus sheath, and peritoneum, are involved in the anatomy of the abdominal wall, the anterior rectus sheath is specifically the layer that needs to be closed to achieve optimal healing and support in the case of an upper paramedic incision. Therefore, its suturing is a critical step in the surgical process.