Essentials in surgical techniques for abdominal wall hernia-repair in children; [Essentials öber Bauchwandhernienverschluss Bei Säuglingen und Kindern]

Abdominal hernia in children are congenital or can occur after laparotomies/ laparoscopies, after blunt abdominal trauma or after abdominal tumour resections. Postoperative abdominal wall hernia can occur after local infections or after severe peritonitis. Further reasons are metabolic diseases, hypoproteinemia and wrong suture material with very low tensile strength or by a wrong suture technique. Preventive and therapeutic measurements are: early diagnosis and treatment of infections, antibiotic therapy, immunological stabilisation by substitution of immunglobulines, intraabdominal pressure reduction using a gastric tube, abdominal drainage and a large abdominal bandage to reduce pressure on the abdominal wound. Duration of intubation and ventilation should be decided in cooperation with the anaesthetist. Control and substitution of potassium is necessary. Closure of the abdominal cavity is performed by sutures of the fascia and the muscle layers together. Single sutures should be performed instead of a continuous suture line. Suture material should not be thinner than 3/0. Removal of suture material is recommended 14 days after abdominal closure. Abdominal drainage should be removed after a secretion less than 10 ml. As soon as bowel movement has started the gastric tube can be removed. Bowel movement is controlled by ultrasound. A close cooperation with the pediatrician is necessary. Physiotherapy of the abdominal wall should be started 4 weeks after hospital discharge for 6 to 12 months. An undisturbed wound healing is dependent on an ecotrophological-determined amount of proteins, carbohydrates, fat and minerals. As a perioperative basic nutrition for children, HIPPR nutrition has proved as an adequate oral or enteral treatment. Physiotherapeutic treatment is necessary for about 6 months postoperative. The most effective and most accepted training method was football for girls and boys. Postoperative investigations have shown that such a training was highly effective. The recommender for soccer training in children is Uli Hoenes, Founder, Stimulator and Sponsor of this activity in early childhood. We have developed these sport activities for children, who have undergone surgery by the so-called therapeutic soccer training. This started the recommendation for all of us: Sport activities in childhood, first of all soccer, are the guarantee for health in adulthood. © 2022 Mediengruppe Oberfranken - Fachverlage GmbH & Co. KG. All rights reserved.