Treatment of unbilical hernias in calves: efficacy of traditional herniorrhaphy and with autologous falp

A hernia is a protrusion of the contents of a body cavity through a weak spot of the body wall. This may be from accidental or a normal anatomical opening, which does not completely fulfill its physiological function. Congenital umbilical hernias are of concern for heritability, although many umbilical hernias are secondary to umbilical sepsis. Multiple births and shortened gestation lengths are two important risk factors for congenital umbilical hernias in calves (1). Uncomplicated umbilical hernias are completely reducible masses with a palpable circumferential hernial ring. While small, uncomplicated congenital hernias may close spontaneously, larger ones or those caused by infection typically require surgical correction. Though infrequent, incarceration with or without strangulation of omentum or gastrointestinal tract segments, such as the abomasum or small intestine, within the hernial sac is possible (2). Herniorrhaphy is the most effective treatment for umbilical hernias, and two main methods are employed to correct this condition: the open approach and the closed approach and with the use or non-use of the autologous flap. A total of 253 subjects presenting with umbilical hernia were considered for our study. The selected subjects came from herds in the province of Ragusa and were between 1 and 4 months old. All calves were prepared for surgery with a fasting phase of 24 to 48 hours with water withdrawal 12 hours before surgery. Before surgery, the animals underwent a thorough clinical pre- anaesthesiologic examination. Anamnesis was collected, general and objective examination of the lesion performed, which included palpation of the swelling. Palpation performed in dorsal decubitus, promoted the reducibility of the lesion by allowing for deeper palpation even beyond the hernial port. Our procedures included an anaesthesiologic protocol under sedation and loco-regional anaesthesia. The operation was performed on 23.32% of the subjects by means of traditional hernioraffy,instead 76.6% by combining traditional hernioraffy with the inclusion and fixation of a peritoneal flap obtained from the incision of the hernia sac itself. The skin was incised in the shape of a crescent; the operation was continued by isolating the herniary sac, with the help of blunt-tipped scissors, or manually, with the fingers. The herniary sac was incised, allowing its contents to be revealed, and the herniary gate and herniated organs, when present, were repositioned in the abdomen. After the sclerotic edges of the door were crucified, and traditional herniorrhaphy was performed in the, applying horizontal U-shaped stitches, in Vicryl 0 or 1 or 2, depending on the size of the animal. Once herniorrhaphy was completed in some subjects, the herniary sac was reduced, shaped and placed over the previous suture and secured with single interrupted Vicryl stitches to act as reinforcement to the herniorrhaphy. This was concluded by suturing the superficial layers (muscle and skin), using a continuous suture for the subcutaneous layer and a suture with single interrupted stitches for the skin.(3) The results obtained describe a high percentage of simple omphalocele (82.21%) compared to omphalocele with viscera dislocation (17.7%) with a high percentage of female (66.79%) and Friesian (69.16%) subjects. Almost all of the operated subjects had a favorable surgical outcome (95.65%) at the expense of 4.34% who had a recurrence. Bringing to the attention of the scientific community the efficacy of hernioraffia by autologous flap allowing a reinforcement that is stable at least for 15 gg postoperatively allowing an excellent tissue compatibility and it was useful to think of exploiting these characteristics of autologous flap so as to perform the functions of prosthesis eliminating the undesirable effects caused by heterologous hips and not of secondary importance the zero cost of autologous material.