Final answer:
To close a right flank laparotomy, the proper order of closure is peritoneum, external rectus sheath, and then subcutaneous tissue. These layers support the abdominal organs, enclose the abdominal muscles, and are just beneath the skin respectively, and must be closed carefully to support healing and prevent complications.
Step-by-step explanation:
When closing a right flank laparotomy, the correct order for the layers of closure is: peritoneum, external rectus sheath, and subcutaneous tissue. It is important to close these layers in the correct sequence to ensure proper healing and to reduce the risk of complications like infection or herniation.
The peritoneum is the innermost layer that lines the abdominal cavity and supports the abdominal organs, consisting of a visceral and a parietal layer with the peritoneal cavity in between. Next, the external rectus sheath, which consists of dense connective tissue covering the rectus abdominis muscles, must be securely closed. Finally, the closure is completed with the subcutaneous tissue, which lies just below the skin and contains fat and smaller blood vessels. This layer is closed to bring the edges of the skin together and minimize the space where seromas or hematomas might form.