Comparative study between two surgical techniques for the treatment of umbilical hernia in calves: preliminary analysis

Umbilical hernia is the protrusion of abdominal contents through a defect in the abdominal wall. In calves, congenital forms may have a hereditary basis, though many cases result from umbilical sepsis. Risk factors include multiple births and shortened gestation (1). Small, uncomplicated hernias may resolve spontaneously, while larger or infected ones often require surgery. In rare cases, herniated omentum or intestinal segments may become incarcerated or strangulated (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. 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. 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,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 show a prevalence of simple omphalocele (82.21%) compared with that with visceral dislocation (17.7%). The majority of operated patients had a favorable surgical outcome (95.65%), with recurrence in 4.34% of cases. We highlight the efficacy of hernioraffy with autologous flap, which provides good stability for at least 15 days postoperatively, excellent tissue compatibility, absence of the undesirable effects associated with heterologous materials, and zero cost.