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This Concept Map, created with IHMC CmapTools, has information related to: Exploratory laparotomy procedure, Step 7:The rumen serosa commonly separates from the peritoneum after puncture of the peritoneum, which allows air to enter the peritoneal cavity. Step 8:Insert your thumbs into the incision at the dorsal and ventral commissures and, as you apply pressure dorsally and ventrally, open the incision the entire length of the skin incision. Step 9:The opening of the incision is primarily for muscle spreading; however, minor muscle tearing may occur. Hemorrhage is generally minimal., Step 9:The opening of the incision is primarily for muscle spreading; however, minor muscle tearing may occur. Hemorrhage is generally minimal. LAST STEP-Suturing The incision is closed via a three-layer suture pattern. -Layer 1: Suture the peritoneum and transverse and internal oblique abdominal muscles together. Use a simple continuous pattern. Use monofi lament absorbable or catgut suture No. 2 or 3. - Layer 2 Suture the external oblique abdominal muscle and subcutaneous tissue. Place an occasional bite into the internal oblique muscle to close dead space. Use a simple continuous pattern. Use monofilament absorbable or catgut suture No. 2 or 3. -Layer 3 Close the skin. A continuous interlocking suture pattern is suggested, but other suture patterns also work well. Use synthetic nonabsorbable, noncapillary suture material No. 3. Place appositional sutures to promote first-intention healing., Step 3:Start at the dorsal commissure of the skin incision and incise the external oblique abdominal muscle ventrally for a distance of about one-third to one-half of the skin incision. Step 4:From the dorsal commissure of the skin incision, incise ventrally the internal oblique abdominal muscle for a distance of about one-half to two-thirds that of the external oblique abdominal muscle incision. Step 5:Then incise the exposed transverse abdominal muscle and the closely associated peritoneum to a length comparable to that of the internal oblique abdominal muscle incision., EXPLORATORY LAPAROTOMY PROCEDURE involves the following steps: Step 1: Start the skin incision just ventral to the lateral edge (caudal aspect) of the transverse process L2, and proceed ventrally parallel to the 13th rib for about 20 cm (8 inches)., Step 1: Start the skin incision just ventral to the lateral edge (caudal aspect) of the transverse process L2, and proceed ventrally parallel to the 13th rib for about 20 cm (8 inches). Step 2: Incise the subcutaneous fascia to a length equal to that of the skin incision, to expose the external oblique abdominal muscle Step 3:Start at the dorsal commissure of the skin incision and incise the external oblique abdominal muscle ventrally for a distance of about one-third to one-half of the skin incision., Step 5:Then incise the exposed transverse abdominal muscle and the closely associated peritoneum to a length comparable to that of the internal oblique abdominal muscle incision. Step 6:By carefully starting the incision at the most dorsal aspect, accidental incising of organ serosa is usually avoided. Scissors may be used to lengthen the incision ventrally. Step 7:The rumen serosa commonly separates from the peritoneum after puncture of the peritoneum, which allows air to enter the peritoneal cavity.