Surgical Care at the District Hospital
Part 1 2 3 4 5 6 Primary Trauma Care Manual
The Abdomen
Laparotomy and Abdominal Trauma
Abdominal trauma
Acute Abdominal Conditions
Assessment and diagnosis
Intestinal obstruction
Stomac and duodenum
Abdominal Wall Hernia
Groin hernia
Surgical repair of inguinal hernia
Surgical repair of femoral hernia
Surgical treatment of strangulated groin hernia
Surgical repair of umbilical and para-umbilical hernia
Surgical repair of epigastric hernia
Incisional hernia
Urinary Tract and Perineum
The urinary bladder
The male urethra
The perineum

Incisional hernias arise after abdominal surgery and are common after caesarean sections and gynaecological operations. They can be difficult to treat because of adhesions of abdominal viscera to the sac and because the size of the fascial defect may be so large that mesh is required for the repair. All but small incisional hernias should therefore be referred for treatment by a surgeon. Suprapubic incisional hernias are particularly complicated and require a surgical specialist to repair.

In the rare event of strangulation of an incisional hernia, operate to save the patient’s life by dividing the fascia and relieving the obstruction. Make your incision through the previous scar. Close the fascia with interrupted monofilament nylon. If this is not possible, close the skin and refer for mesh closure.

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