How to improve the prognosis of ventral abdominal hernias in large animals: "modified" overlapping technique

Abstract

A "modification" of the conventional overlapping mattress for repair of hernia ring was tried and observed to improve the prognosis of ventral abdominal hernias. The modification consisted of separating the tissues forming the hernia opening, into two or three layers and then overlapping each subsequent layer to the opposite side of the preceding layer overlap. This was termed "modified double layer overlapping" technique. Over-sewing the outer-most layer with cushing suture pattern, followed by use of horizontal mattress for skin closure further reinforced the hernia closure. Twelve cases including 6 bovine, 4 ovine and 2 caprine are described. A comparison in some of these cases reveals recurrence of hernia when conventional overlapping mattress is used and a complete healing when the same hernias are repaired with "modified overlapping technique". Factors observed to influence prognosis of ventral hernias are: location, size of the tear (opening), as we" as thickness and firmness of the tissues composing the edges of the ring as determined by presence or absence of ring fibrosis. Hernias on a more ventral abdominal location, with large tears and lack of definite fibrous ring have poor prognosis. Infection was observed to worsen the prognosis.