WARNING:
JavaScript is turned OFF. None of the links on this concept map will
work until it is reactivated.
If you need help turning JavaScript On, click here.
This Concept Map, created with IHMC CmapTools, has information related to: Umbilical Herniorrhaphy, The hernia sack is then excised so that the remaining tissue is flush with the abdominal wall. Step 5, The SQ layers are then apposed using the Subcuticular-Continous Suture pattern & 2-0 PDS suture material. It is recommended to take bites including the abdominal wall layer intermittentl, in order to eliminate dead space. The end is buried using an Aberdeen knot. Step 7, The abdominal wall layers are apposed using the Vest-Over-Pants Suture pattern & 0-Prolene suture material. It is recommened to use the halfway method, place all the bites first and then tie all the knots using a surgeon's knot succeeded by 5 basic square knots per suture. N.B: This case required 6 sutures to be placed. Step 6, Step 1 ???? Palpate to get an idea of the type of umbilical hernia you are dealing with & determine the best course of action. N.B: This occurs pre-op before the dirty scrub is done., Step 3 A stab incision is then made using a blunt instrument through the body wall in order to expose the abdominal cavity., Step 6 The SQ layers are then apposed using the Subcuticular-Continous Suture pattern & 2-0 PDS suture material. It is recommended to take bites including the abdominal wall layer intermittentl, in order to eliminate dead space. The end is buried using an Aberdeen knot., Pre- Op followed by Intra- Op, Preparation of the Patient 3. Dirty Scrub The hernial site, as well as the surrounding areas are scrubbed dilute chlorhexidine until no visible dirt was noted. To complete the dirty scrub a gauze soaked in iodine was used to wipe the operating site from the hernia outwards, Preparation of the Patient 1. Positioning Patients undergoing umbilical hernia surgeries are more often placed in dorsal recumbency on the operating table., It can be either; 3. Umbilical hernia w/ localised, SQ infection/ abscess, Once Pre-Op is complete, you begin by making an eliptical skin incision around the affected area. The skin is dissected and undermined away from the SQ tissue. Step 3, Preparation of the Patient 4. Surgical Prep The site was aseptically prepared by the operating surgeons. Use of dilute chlorhexidine and iodine applied in a 'circular' fashion from incision site outwards. Surgical drapes were then placed around the hernial site and secure with towel clamps, Pre-Op Induction, Umbilical Herniorrhaphy initially requires Pre-Op, Pre- Medication may include Appropriate antibiotics and analgesics, Pre-Op Physical examination: Both Distance and Hands-on should be conducted. TPR values should be noted (T-39.2 C, P- 48bpm, R- 56bpm). The hernia should be assessed via digital palpation to determine the approximate size beforehand and if it may be complicated., Anaesthesiology Step 1 Pre- Medication, Pre- Medication may include Preanaesthetic agents, The skin is closed using both the Cruciate & Simple-Interrupted Suture pattern & 1-Prolene. It is recommended to use the halfway method and ensure the sutures aren't placed too tightly to allow for the expected post-op swelling. Step 8, Maintenance Maintenance of Anaesthesia may be done in many ways. A constant rate infusion with a 0.9NaCl bag, infused with 10mls Xylazine, Ketamine and Lidocaine each, was attached to the ear vein catheter and ran through at approximately 1 drop/sec until the surgery was completed. Due to complications, a catheter was placed in the left hindlimb and regular top ups of xylazine/ketamine were given to assist maintenance. Another method is via Gas anaesthesia, by which an endotracheal tube that is attached to the common gas outlet of an anaesthetic machine (and subsequently an inhalant anesthetic), can be inserted into the mouth of the patient to maintain anaesthesia.