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: lab 8 (mnh), Presurgical Procedures include Deprivation of food and water Similar to that used for general anesthesia Decreases bulk and bloat during surgery Calves given an all-milk diet should not have milk withheld., Restraint and Anesthesia involves General anesthesia is recommended. Heavy sedation with local anesthesia is acceptable. Movement of the patient during the procedure may jeopardize a surgical success. Place the patient in dorsal recumbency on a basically level plane. The patient’s head may be placed at a slightly lower level to preclude the possibility of aspiration of regurgitated material if an endotracheal tube is not used. Consider placing a nasotracheal tube in heavily sedated calves to maintain a patent airway., Dissection of the tissue if No Suspected Abscess / Infection, Suspected Abscess / Infection or if Abscess / Infection in Blood Supply, Abscess / Infection in Blood Supply then When evidence of an abscess or infection is found in umbilical arteries, vein or urachus: ◆ Carefully expose infected structures and remove them. ◆ Extending the incision posteriorly may be required. ◆ Occasionally, the urinary bladder will be involved. When evidence of an abscess or infection is found in the umbilical vein: ◆ Marsupialization of the stalk of the umbilical vein through the abdominal wall and skin anteriorly and to the right of the midline allows drainage and lavage to remove the infection., Dissection of the tissue involves ● The lateral edges of the skin incision require separation from the hernial sac to expose the junction of the hernial sac and abdominal wall. ● Significant hemorrhage often occurs during this stage. ● Blunt dissection with scissors helps control hemorrhage and incising abscesses or infected tissue. ● Manual blunt dissection with a 4 × 4–inch gauze pad gives the quickest result with least hemorrhage., Restraint and Anesthesia also consider Presurgical Procedures, ● A standard elliptic incision encompassing the hernia is effective. ● A double-V incision can be used with a good cosmetic result. like so, ● The lateral edges of the skin incision require separation from the hernial sac to expose the junction of the hernial sac and abdominal wall. ● Significant hemorrhage often occurs during this stage. ● Blunt dissection with scissors helps control hemorrhage and incising abscesses or infected tissue. ● Manual blunt dissection with a 4 × 4–inch gauze pad gives the quickest result with least hemorrhage. like so, Abscess / Infection in Blood Supply then Closure, No Suspected Abscess / Infection then For a relatively small, abscess-free hernia: 1. Invert the hernial sac into the abdominal cavity. 2. “Freshen” (scarify) the edges of the hernial ring. 3. Close the hernial ring with simple interrupted sutures. This technique does not require an open abdominal cavity and is preferred when surgery is performed in a location that is less than ideal (e.g., barn, outdoors)., No Suspected Abscess / Infection but if Suspected Abscess / Infection, ● A standard elliptic incision encompassing the hernia is effective. ● A double-V incision can be used with a good cosmetic result. like so, Closure involves For a hernial sac and abdominal cavity that are not open: ◆ Freshen the edges of the hernial ring by scarification. ◆ Invert the hernial sac. ◆ Close the abdominal wall over the sac via simple interrupted sutures. ◆ Use large suture bites with a sufficiently strong, sterile suture material to allow healing For an open hernial sac and abdominal cavity: ◆ Close the abdominal wall with simple interrupted sutures. ◆ Use large suture bites in a one-layer closure with sufficiently strong, (#2 or #3)sterile suture material to allow healing. An alternative is to dissect the abdominal wall into two layers and close each layer separately. The interior layer is primarily peritoneum, and the outer layer is fibrous connective tissue. ◆ Two layers allow the use of smaller diameter (#0 or #1) suture material andincrease the strength of the suture line. For a nearly round defect in the abdominal wall, extend the incision both anteriorly and posteriorly to facilitate closure. To avoid excessive tension in the incision: ◆ Use a far-near-near-far suture pattern. ◆ Use surgical mesh incorporated into the incision, although the high cost of mesh must be considered. ★ Do not put mesh into a contaminated or infected wound. An overlapping suture pattern (“vest-over-pants”) may be used. ◆ Recent evidence indicates that this pattern may cause ischemia of the incision site, with an increased possibility of dehiscence. ◆ To reduce concern about dehiscence, place a simple continuous suture at the free edge of the overlapping tissue. Subcutaneous tissue ● Subcutaneous tissue is generally closed via a continuous suture pattern with an absorbable material. ● The objective of closure is to decrease dead space, which reduces fluid accumulation and swelling. Skin ● Heavy synthetic nonabsorbable noncapillary suture material (#1 or #2) is typically used in a simple interrupted or interrupted horizontal mattress pattern., Surgical Technique for the Treatment of Umbilical Hernias firstly Restraint and Anesthesia, Skin incision involves ● A standard elliptic incision encompassing the hernia is effective. ● A double-V incision can be used with a good cosmetic result., ● A standard elliptic incision encompassing the hernia is effective. ● A double-V incision can be used with a good cosmetic result. like so, Presurgical Procedures followed by Skin incision, Skin incision followed by Dissection of the tissue, Suspected Abscess / Infection then For a present or suspected abscess or umbilical infection: Make a small incision—large enough to insert one finger—into the abdominal cavity at the base of the hernial sac on the lateral side. Digitally examine the contents of the hernial sac. An empty hernial sac may be removed and discarded. If adhesions are present within the hernial sac: Extend the abdominal incision to allow separation of the adhesions and abdominal contents (usually omentum). Return contents to the abdominal cavity. Remove and discard the hernial sac.