Umbilical hernia is a surgical disease in which abdominal organs (mostly the small intestine and omentum) are formed by the umbilicus off the skin. The disease is common in calves and is generally congenital. With the growth of calf's body, the umbilical hernia will become larger and larger, which will affect the growth and development of calves. Surgical treatment is applied to the diseased calves and they heal well after surgery. The situation is reported as follows.
1 Cause of disease
1.1 Causes of postoperative recurrence
The surgical procedure was not repaired in accordance with the hernia repair procedure. In particular, the hernia wheel suture was not tight enough, and the hernia round was not healed after the scar was not cut into fresh wounds and then sutured.
1.2 Causes of complicated hernia abscesses
Sterility in the surgical procedure is not critical, especially sutures in the suture wheel are contaminated, contaminated sutures are implanted to cause an abscess in the hernia, and the umbilical hernia occurs due to the herniation of the hernia.
2 symptoms
In addition to the symptoms of umbilical hernia, there are also inflammatory reactions such as heat and pain. The hernia sac is locally tender and soft. There is a fist-sized induration inside the hernia sac. The needle punctures the hard knot and flows out of the white viscous pus. Repeatedly rubbing with the ground and thickening, there is a volleyball ball size.
3 Surgical treatment
3.1 Preoperative preparation
Preoperative ban for feeding for 36 hours, appropriate amount of drinking water can be given to reduce intra-abdominal pressure and select the right side of the surgical site under Baoding. The diseased cow is lying on the right side of the forequarters, and the back is half supine Baoding. General anaesthesia was performed with intramuscular injection of 846 mixture at 0.01 mL/kg, and 0.5% of procaine hydrochloride was infiltrated along the incision. Shaving, cleaning and disinfecting routine operations.
3.2 Surgical methods
First abscess surgery, and then repair hernia.
3.2.1 incision in the base of the abscess, along the abscess around the shuttle-shaped incision, the incision before and after the two ends of the hernia sac extended, the length of the hernia sac more than the diameter of the hernia sac skin to take open the wall, ligation of the bleeding point, fully Expose the fibrous capsules. First, a small hole was cut in the fibrous capsule with a curved shear and a finger was inserted to probe the adhesion of the fibrous capsule to the contents of the fistula. It was found that the fibrous capsule partially adhered to the prolapsed omentum. The assistant used two hemostats to hold the fibrous capsule. Speaking, the surgeon carefully expanded the incision at the non-adhesive site. At this time, the fibrous capsule and the abscess wall could not be peeled off to prevent the abscess wall from being punctured and causing contamination. The fibrous capsule and the omentum were first peeled off with a curved blunt surgical scissors. After the peeling was complete, the abscess was removed together with the adherent fibrous capsule portion.
3.2.2 After the omentum is flushed with normal saline, it is returned to the abdominal cavity, and is covered with a gauze pad to prevent it from escaping. Use a round needle on the 10th double-stranded wire to make a distance of 1.5 to 2.0 cm from the rear of the reed. The horizontal button sewing, from the outside of the needle into the needle, the inside of the needle, and then from the inside of the opposite side of the needle into the needle, outside the pin wheel out of the needle, and then from the outside side of the same pin into the needle, inside the pin wheel out, to The inside of the contralateral reed is inserted into the needle, and the outside of the reed reel is needled. A horizontal button sewing is performed. The line is aligned with a hemostatic forceps and fixed on the wounded towel. A penicillin is scattered in the abdominal cavity when the last horizontal buttons are sewn. When the suture is tensioned and knotted, the surgeon and the assistant are required to cooperate. When the surgeon tightens the first knot, the assistant clamps with the hemostat, and the surgeon hits the second knot to tighten the second knot. At the same time, the assistant quickly removes the hemostat to ensure that each knot can be tightened. Then use a scalpel or surgical scissors to trim the scarring of the hernia wheel into fresh wounds, and then perform a layer of nodular suture on the fresh wound surface of the hernia wheel. Afterwards, rinse with normal saline and spread the penicillin. Finally, trim the fibrous capsule and double suture.
3.2.3 Trim the excess skin sac, and then make a continuous suture of the subcutaneous tissue. Afterwards, rinse with saline and spread penicillin. The iodine ball was used to disinfect the skin margin and the skin was sutured from posterior to anterior. After suturing, skin nodules were sterilized with iodine, skin wounds were tied to bandages, and suture knots were sterilized with iodine.
4 Experience
4.1 Preoperative preparation for umbilical hernia treatment must be adequate. The diseased cow must be fasted and watered for more than 36 hours in order to fully reduce the intra-abdominal pressure, which will facilitate the operation and increase the success rate of the operation.
4.2 When the abscess is removed, pay attention to the integrity of the abscess membrane. If there is abscess rupture of the abscess membrane, wipe it with an iodine swab as soon as possible, then rinse with normal saline and pay attention to the contamination of the instrument. When the fibrous capsule and the omentum adhesion part of the peeling, the surgical scissors should be close to the fibrous capsule, while peeling edge with the index finger to test the depth and extent of peeling, if peeling the adhesion part of the omentum damage, must be omentum Continuous suture. After knotting is complete, it should be judged whether or not the wheel is closed tightly. If there is a loose knot, the knot must be re-stitched again. When pruning the scar turn, be sure to trim until bleeding. The skin of the operative area should also be trimmed so that the skin can be butted tightly, reducing effusion and facilitating healing of the wound.
4.3 The diseased cattle were reared separately and contact with feces was reduced. Some digestible feeds were given. A small amount of meals was used. The first two days gave 1/4 of the fed amount. The third day gradually increased the food intake. 7 days returned to normal, intramuscular injection of penicillin for 7 days after surgery to prevent surgical infection, 10 days after the removal of skin sutures, and iodine disinfected skin wound.
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