METHOD FOR PLASTY OF DEFECTS IN THE ANTERIOR ABDOMINAL-WALL IN CHILDREN

Experimental studies were conducted on 60 cadavers of children whose ages ranged from 0 to 14 years. A defect measuring 6-10 cm was formed in the muscles of the anterior abdominal wall (an approximate model of a hiatal opening). Several rows of crimping sutures were then applied to the aponeurosis of the rectus abdominis muscle above and below the defect. The force of stretching of the edges of the defect was studied by an elaborated tensiometric device after application of each row of crimping sutures. It was found that application of two or three rows of crimping sutures above and below the ventral defect ensures reliable decrease of the stretching load exerted on its edges and allows them to be sutured without tension. The optimal zones in the operative field for applying the crimping sutures were also determined. On the basis of experimental study the authors developed and used in the clinic a method for autoplasty of ventral hernias based principally on placing sutures through the edges of the ventral defect only after their approximation, after priliminary removal of the stretching load experienced by the laparotomic wound. The authors used this method of plasty successfully in 9 children with ventral hernias whose ages ranged from 2 to 14 years.