An incarcerated hernia may be defined as a hernia in which the co

An incarcerated hernia may be defined as a hernia in which the contents have become irreducible due to a narrow opening in the abdominal wall

or adhesions within the cavity. Intestinal obstruction can complicate an incarcerated hernia. In contrast, a strangulated hernia is one in which the blood supply to the contents of the hernia (eg omentum, bowel) s becomes compromised [2]. Strangulated click here hernias remain a significant challenge, as they are sometimes difficult to diagnose purely by physical examination yet require urgent surgical intervention. Early surgical intervention of a strangulated hernia with obstruction is crucial as delayed diagnosis can lead to bowel resection with longer MK-8931 solubility dmso recovery and its attendant complications. Strangulated hernias can have serious deleterious effects such as, bowel obstruction, bacterial translocation, and intestinal wall necrosis (potentially resulting in bowel perforation). It poses a significant risk to emergency hernia repair, as there is an increased incidence of surgical field contamination, leading to high rates of post-operative infection and probably recurrence. Bacteria inherently colonize all surgical wounds, but only a fraction

of these contaminates ultimately lead to infection. In most patients infection does not occur because innate host defences are able to eliminate microbes at the surgical site. However, there is some evidence that the implantation of foreign materials, such as prosthetic mesh, may lead to a decreased threshold for infection [3]. While many factors can influence surgical wound healing and post-operative infection, bacterial burden is the most significant risk factor. Wounds are classified according to the likelihood and degree of wound contamination at the time of operation. Classifications include: clean wounds, clean-contaminated wounds, contaminated wounds, and dirty or infected wounds [4]. The pathogens involved in an infection depend on the type of surgery. In an aseptic surgical procedure, Staphylococcus

aureus is a common source of infection, either from the patient’s own skin flora or surrounding environment. Surgeons can minimize the risk of infection and associated complications by routinely employing site-specific spectrum antibiotic prophylaxis. Resminostat In clean-contaminated, contaminated, and dirty surgical procedures, the polymicrobial aerobic and anaerobic flora closely resemble the normal endogenous microflora of the gastrointestinal (GI) tract and are the most frequently observed pathogens. The contaminating pathogens in GI surgery include gram-negative bacilli (e.g., Escherichia coli) and gram-positive microbes, such as enterococci and anaerobic organisms. A classification scheme has been demonstrated in multiple studies to predict the relative probability that a given wound will become infected [5, 6].

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