Management of incisional herina – a case study
Journal name: World Journal of Pharmaceutical Research
Original article title: Management of incisional herina – a case study
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Dr. Nutan Valmik Sanap, Dr. Bharat K. Oza and Dr. Madhavi S. Banarase
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Management of incisional herina – a case study
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr202112-21756
Copyright (license): WJPR: All rights reserved
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Summary of article contents:
Introduction
Incisional hernia is a common complication following abdominal surgery, with an incidence rate estimated between 10% and 20% after midline incisions. Various factors contribute to the development of incisional hernias, such as advanced age, obesity, smoking, and diabetes. This case study presents a 65-year-old female patient who underwent multiple abdominal surgeries and developed an incisional hernia, leading to abdominal swelling, pain, and anorexia. The management of her condition through surgical repair, specifically hernioplasty, highlights the importance of addressing incisional hernias to prevent complications.
Surgical Repair Techniques
One of the critical aspects of managing incisional hernias is the surgical approach employed. In the referenced case, the surgical strategies involved simple apposition, complex apposition, and plastic mesh techniques. The procedure began with the patient in a supine position, under epidural anesthesia, where a midline incision was made over the hernial site. Through meticulous dissection and identification of the hernial defect, the omentum was separated, and the posterior rectus fascia was accessed. A mesh was used to reinforce the repair, which was then secured in the retromuscular plane, ensuring a tension-free closure to optimize healing and minimize the risk of recurrence.
Risk Factors and Aetiology
The aetiology of incisional hernias encompasses a range of predisposing factors. Vertical and midline scars, particularly from major surgical operations, can create vulnerabilities in the abdominal wall. Additionally, factors such as poor nutritional status, presence of chronic cough, or conditions that elevate intra-abdominal pressure like constipation or benign prostatic hyperplasia also contribute to the risk. The case study underscores that poor surgical technique and postoperative complications, such as infection or inadequate wound healing, further increase the likelihood of developing an incisional hernia.
Postoperative Care and Management
Postoperative care is vital after incisional hernioplasty to ensure optimal recovery and prevent complications. In the reported case, the patient received intravenous antibiotics post-surgery and transitioned to oral medications after a few days. Monitoring for potential complications such as fluid buildup, postoperative bleeding, and infections is essential. Proper wound care and follow-up appointments are also crucial to ensure that the patient heals well and any issues are addressed promptly. A careful approach during this phase can significantly influence recovery outcomes and long-term success.
Conclusion
Incisional hernias represent a significant challenge in surgical recovery, and understanding their management is vital for healthcare professionals. The case study illustrates the critical importance of recognizing risk factors, employing effective surgical techniques, and providing thorough postoperative care. As incisional hernias can arise from a variety of causes, effective preventative measures and careful management can help reduce their incidence and impact on patients’ lives. Overall, this highlights the need for continued education and awareness in surgical practices to improve patient outcomes.
FAQ section (important questions/answers):
What factors influence the incidence of incisional hernias?
Incisional hernias can arise from factors like age, obesity, previous surgeries, and infection rates. Other contributing factors include suture type and comorbidities such as diabetes and hypertension.
What are the common symptoms of an incisional hernia?
Common symptoms include abdominal swelling at the surgical site, abdominal pain, anorexia, and tenderness. These symptoms may worsen over time and can lead to complications if not treated.
What surgical techniques are used to treat incisional hernias?
Surgical repair techniques include simple apposition, complex apposition, and the use of mesh. The choice depends on the size and nature of the hernia, with most procedures aiming for a tension-free closure.
What preparations are required before incisional hernia surgery?
Preparations include controlling underlying conditions like diabetes, conducting pre-operative tests, ceasing certain medications, and fasting. Pre-operative antibiotics are also typically administered to prevent infections.
What complications can arise from incisional hernia surgery?
Possible complications include fluid buildup, bleeding, prolonged pain, intestine or nerve injuries, infection, urinary retention, and respiratory issues. Close monitoring during recovery helps manage these risks.
How common are incisional hernias after abdominal surgeries?
Incisional hernias are a frequent complication of abdominal surgeries, occurring in approximately 10% to 20% of cases following midline incisions. This makes awareness and preventive measures essential.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Management of incisional herina – a case study”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Study (Studying):
The study refers to a systematic investigation of a phenomenon or medical case. In this context, it focuses on a single case of incisional hernia treated through hernioplasty. Understanding the case in detail contributes to medical literature, aiding future assessments and providing insights into similar surgical complications and their management.
2) Swelling:
Swelling is a common clinical symptom found in various medical conditions, including hernias. In this case, the patient presented with abdominal swelling indicative of an incisional hernia. The swelling can indicate complications or the presence of abnormal tissue, requiring careful evaluation and appropriate surgical intervention.
3) Ayurveda (Ayus-veda):
Ayurveda is an ancient system of medicine from India that emphasizes balance in bodily systems and uses natural therapies. Its relevance in this case study underscores the integration of traditional Indian medical practices with contemporary surgical techniques, showing the holistic approach taken to treat conditions like incisional hernia.
4) Incision:
An incision is a surgical cut made in the skin or flesh during an operation. In the context of this study, incisions have significant implications as they can lead to complications such as incisional hernias, highlighting the importance of proper surgical techniques and post-operative care in minimizing risks.
5) Post:
Post refers to the period after surgery, commonly highlighted in clinical studies to assess recovery and complications. In this case, post-surgical care was crucial to monitor the patient’s recovery, prevent infections, and manage any complications that could arise from the surgical intervention.
6) Pune:
Pune is a city in India where the case study was conducted. Its significance lies in being the location of the Ayurvedic hospital involved in the patient's treatment. The geographical context can influence the availability of healthcare resources and cultural approaches to treating specific medical conditions.
7) Wall:
In medical terminology, the wall often refers to the structural barriers of the body, such as the abdominal wall in this case of hernia. The integrity of the abdominal wall is critical, as weaknesses due to surgery or other conditions can lead to herniation and necessitate surgical repair.
8) Antibiotic (Antibacterial):
Antibiotics are medications used to prevent or treat infections. In postoperative care, antibiotics are crucial for reducing the risk of surgical site infections. The administration of antibiotics to the patient after hernioplasty illustrates the standard practice of ensuring patient safety and enhancing healing post-surgery.
9) Pain:
Pain is a common symptom associated with many medical conditions, including post-surgical recovery. In this case, the patient experienced abdominal pain related to her incisional hernia, underscoring the importance of monitoring pain levels and providing effective pain management strategies as part of comprehensive patient care.
10) Repair:
Repair refers to the surgical intervention aimed at correcting a defect, such as an incisional hernia. The hernioplasty performed in this case involved meticulous techniques to restore the integrity of the abdominal wall, showcasing the importance of surgical skills and appropriate methods in hernia management.
11) Shalyatantra (Salyatantra, Shalya-tantra, Shalyatamtra):
Shalyatantra, similar to Shalya-tantra, refers specifically to the surgical branch of Ayurveda. The incorporation of Shalyatantra in this study highlights a traditional approach to surgery that may offer unique insights and methodologies for contemporary surgical practices and enhances the understanding of incisional hernia management.
12) Dressing:
Dressing refers to the cover applied to a wound or incision post-surgery. In hernia repair cases, maintaining proper dressing technique is crucial to prevent infection and promote healing. The frequent dressing changes in this case signify a commitment to optimal wound care and recovery monitoring.
13) Disease:
Diseases encompass various pathological conditions that affect health. In this case, references to diseases such as diabetes, hypertension, and cardiovascular issues highlight the importance of understanding a patient’s comorbidities, as they can significantly influence surgical outcomes and postoperative care.
14) Tantra (Tantrism, Tamtra):
Tantra often refers to a field of knowledge or techniques in Ayurvedic practice. In this context, it highlights the traditional methodologies used in surgical procedures. The integration of tantra in Ayurvedic healing emphasizes a holistic approach, encompassing both spiritual and physical dimensions of health and treatment.
15) Shalya (Salya):
Shalya translates to surgical science or surgery in Ayurveda. Its relevance in this study signifies the important role of ancient healing practices alongside modern medicine, aiming for comprehensive treatment approaches for surgical cases such as incisional hernias.
16) Valmika:
Valmik is the first name of the lead author of the case study. The involvement of qualified professionals like Dr. Nutan Valmik Sanap in this study is essential for ensuring the integrity and reliability of the research findings, contributing to best practices in the field.
17) Blood:
Blood is a vital fluid that transports oxygen and nutrients throughout the body. In the context of surgery, monitoring blood levels, including hemoglobin and platelet counts, is crucial to assess the patient’s health status and possible risks during and after surgical procedures.
18) Pur:
Poor in this case likely refers to suboptimal health conditions affecting the patient. Poor nutritional status or health can predispose to surgical complications, emphasizing the need for thorough preoperative assessments and nutritional support to enhance postoperative recovery and minimize risks.
19) Tuberculosis:
Tuberculosis (TB) is a serious infectious disease that affects the lungs and can have systemic effects. Its mention in the context of this case brings awareness to potential pre-existing conditions that might complicate surgical outcomes, demonstrating the importance of assessing a patient’s entire health status preoperatively.
20) Malnutrition:
Malnutrition refers to deficiencies, excesses, or imbalances in a person's intake of energy and nutrients, impacting recovery and overall health. In surgical cases, malnutrition can increase risks of complications, emphasizing the necessity for nutritional assessments and interventions before and after surgery.
21) Discussion:
Discussion is a crucial component of case studies, where authors analyze the findings, integrate existing literature, and highlight implications. In this paper, the discussion around the management of incisional hernia allows for reflection on surgical techniques and patient care strategies, fostering improved practices in the field.
22) Developing:
Developing in this context may refer to the process of emergence or worsening of conditions, such as incisional hernia following surgical intervention. It emphasizes the need for vigilance in monitoring patients post-surgery to address any emerging complications proactively.
23) Painting:
Painting in a surgical context refers to the application of antiseptics or preparations on the surgical site. It is vital for preventing infections before surgery, ensuring that the area is sterile, and reducing the risk of complications during and after the operation.
24) Bleeding:
Bleeding during or after surgery poses significant risks, including shock and compromised recovery. In this study, monitoring for bleeding is essential to ensure patient safety, and preoperative assessments and surgical techniques are aimed at minimizing this risk during hernioplasty.
25) Debility:
Debility refers to a state of physical weakness or frailty. In surgical patients, debility can complicate recovery and increase the risk of complications, necessitating comprehensive preoperative evaluations and postoperative care focused on restoring strength and overall health.
26) Madhavi:
Madhavi is the name of one of the authors involved in the study. The presence of multiple qualified contributors highlights the collaborative effort in research, enhancing the credibility and depth of the findings while fostering a multidisciplinary approach to complex medical cases.
27) Family:
Family history can provide vital information about hereditary diseases or conditions that could influence a patient's health. In this study, investigating family medical history may reveal genetic predispositions to conditions affecting recovery and surgical outcomes, guiding preoperative assessments.
28) Nature:
Nature might refer to the characteristics of the patient’s condition or treatment approach. In this case, understanding the nature of the incisional hernia is critical for implementing appropriate surgical techniques and anticipating potential complications during management.
29) Ulcer:
An ulcer is a sore that develops on the skin or mucous membrane, often indicating underlying structural issues. In the context of this study, the presence of ulcers in relation to hernias highlights the complexity of patient conditions, necessitating comprehensive treatment strategies.
30) Fever:
Fever is a common sign of infection and can occur post-surgery. The monitoring of fever after hernioplasty is critical to identify and address potential infections early, ensuring timely interventions that can significantly affect patient recovery outcomes.
31) Drug:
Drug refers to any chemical substance used for medical purposes, including treatment or prevention of disease. In the context of this case, drugs such as analgesics and antibiotics are critical components of both preoperative optimization and postoperative care to ensure patient safety and recovery.
32) Diet:
Diet encompasses the food and nutrition intake of a patient, which plays a crucial role in preoperative and postoperative recovery. In this case study, dietary considerations may contribute to strengthening the patient’s health status, promoting better surgical outcomes, and preventing complications.
33) Line:
Line may refer to the administration of intravenous lines for delivering medications and fluids during surgery. The technique and management of IV lines are essential for ensuring that patients remain stable throughout surgical procedures and recover effectively during the postoperative phase.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Management of incisional herina – a case study’. Further sources in the context of Science might help you critically compare this page with similair documents:
Preoperative preparation, Postoperative care, Diagnostic imaging, Postoperative complication, Risk factor, Surgical repair, Observational case study, Anesthesia technique, Abdominal swelling, Suture material.