METHOD OF REDUCING TIGHTENING OF SEWINGS IN PROSTHERIC HERNIOPLASTY OF UMBILICAL HERNIAS WITH LARGE DIASTASIS RECTI ABDOMINIS

摘要

FIELD: medicine.;SUBSTANCE: interrupted stitch is imposed on the edge of hernial orifice at its maximum width level corresponding to the level of the umbilical ring, and its tension is measured. When the stitches tension is less than 10 Newtons, a relaxative incision of the aponeurotic sheath of rectus abdominis muscles is not performed. In the case of stitches tension of 10 Newtons or more, after a hernioplasty, a relaxative incision of the aponeurotic sheath of the rectus abdominis muscles is performed. Incision is performed in the form of curved lines in conventional boundaries of vertical, held on the outer edge of the rectus, interior, held at the inner edge of the rectus, top, held at 1.5-2.0 cm above the center of hernial orifice, bottom, held at 1.5-2.0 cm below the center of hernial orifice. As a result of performing the relaxative incisions, lateral and medial flaps of the interior wall of aponeurotic sheath of the rectus abdominis muscles are formed that move relative to each other due to the tension created by the threads of stitches. The defects of interior wall of aponeurotic sheath of the rectus abdominis muscles, formed as a result of relaxative incisions, are sutured with interrupted stitches.;EFFECT: method reduces the incidence of complications in the early and late postoperative periods.;7 tbl, 3 dwg