1.
Most staged hernia repairs fall into which two categories?
Correct Answer
A. Two-stage hernia repair & Open abdomen hernia repair
Explanation
Staged hernia repairs can be classified into two categories: two-stage hernia repair and open abdomen hernia repair. Two-stage hernia repair involves performing the repair in two separate stages, typically with an initial temporary closure followed by a definitive repair. Open abdomen hernia repair, on the other hand, refers to a surgical technique where the abdomen is left open after hernia repair, allowing for ongoing monitoring and potential closure at a later stage. Therefore, the correct answer is Two-stage hernia repair & Open abdomen hernia repair.
2.
A hernia field may become contaminated as a result of (check all that apply):
Correct Answer(s)
A. Enterocutaneous fistula
B. Traumatic injury to the bowel
C. Operations on the digestive track
Explanation
A hernia field may become contaminated as a result of an enterocutaneous fistula, which is an abnormal connection between the intestines and the skin. This can allow bacteria from the intestines to enter the hernia field and cause infection. Traumatic injury to the bowel can also lead to contamination as it can cause a rupture in the bowel, allowing bacteria to enter the hernia field. Operations on the digestive track can introduce bacteria into the hernia field if proper sterile techniques are not followed. Primary suture closure of the hernia defect may not directly cause contamination, but if there is an underlying infection or contamination present, closing the hernia defect may trap the bacteria inside and worsen the infection.
3.
Planned ventral hernia is termed as such because the surgeon knows that the viscera are
likely to protrude through the hernia defect after the first stage is complete, therefore a
second surgery is anticipated.
Correct Answer
B. True
Explanation
The explanation for the given correct answer is that a planned ventral hernia is termed as such because the surgeon knows that the viscera are likely to protrude through the hernia defect after the first stage is complete, therefore a second surgery is anticipated. This means that the statement is true.
4.
When infection is present and two-stage hernia repair is needed, what steps are involved
in the first stage to treat the patient? Check all that apply.
Correct Answer(s)
A. Debriding of the wound
B. Draining of the wound
C. Antibiotic therapy
Explanation
In the first stage of two-stage hernia repair when infection is present, several steps are involved in treating the patient. Debriding of the wound is necessary to remove any dead or infected tissue. Draining of the wound is important to allow any fluid or pus to be released. Antibiotic therapy is essential to combat the infection and prevent its spread. However, repair of the wound with prosthetic mesh is not typically done in the first stage as it is usually reserved for the second stage of the procedure.
5.
What recent developments have allowed for definitive single-stage repair in the presence
of contamination or infection?
Correct Answer
D. A & B
Explanation
The recent developments that have allowed for definitive single-stage repair in the presence of contamination or infection are the introduction of biological meshes and the component separation technique. Biological meshes are materials derived from human or animal tissue that can be used to reinforce weakened or damaged tissue. The component separation technique involves separating layers of tissue in order to close large defects without tension. These advancements have improved the success rates of surgeries in contaminated or infected areas, allowing for a single-stage repair. Synthetic meshes are also an option for repair, but they are not specifically mentioned as contributing to definitive single-stage repair in the presence of contamination or infection.
6.
When the abdominal wall wound is so large that skin cannot be closed over it the surgeon
may use an open abdomen approach, leaving the wound open to air until the patient has
time to heal.
Correct Answer
B. False
Explanation
The open abdomen is never actually left open to air, instead the surgeon covers the
wound with a suitable dressing that protects the abdominal contents from drying out,
becoming infected or becoming necrotic.
7.
An extreme increase in pressure within the abdominal cavity that disrupts blood flow to the
organs is known as:
Correct Answer
A. Abdominal compartment syndrome
Explanation
Abdominal compartment syndrome refers to a condition where there is a sudden and significant increase in pressure within the abdominal cavity. This increased pressure can disrupt blood flow to the organs, leading to various complications. The other options, component separation and open abdomen syndrome, do not specifically refer to the extreme increase in pressure within the abdominal cavity. Therefore, the correct answer is Abdominal compartment syndrome.
8.
Surgeons attempt to reduce edema and advance wound closure by:
Correct Answer
B. Applying negative pressure to the wound
Explanation
Applying negative pressure to the wound is a technique used by surgeons to reduce edema and promote wound closure. Negative pressure wound therapy involves placing a vacuum dressing over the wound, which creates a controlled suction that helps remove excess fluid and promote blood flow to the area. This technique can help reduce swelling and improve healing by stimulating the formation of granulation tissue. Therefore, the correct answer is applying negative pressure to the wound.
9.
What morbidities are associated with planned ventral hernias? Check all that apply.
Correct Answer(s)
A. Exposed bowel, which is prone to fistula
B. Long hospital stay
C. Large, unsightly and possibly painful hernia bulge
Explanation
Planned ventral hernias can be associated with several morbidities. One of these is exposed bowel, which is prone to fistula formation. This means that the bowel may become exposed through the hernia defect, increasing the risk of a fistula developing. Another associated morbidity is a long hospital stay, as ventral hernia repair surgery often requires a significant recovery period. Additionally, patients may experience a large, unsightly, and possibly painful hernia bulge. This can cause discomfort and affect the patient's quality of life. However, skin necrosis is not mentioned as an associated morbidity in this question.
10.
Why was AlloDerm chosen as the biological mesh to be used in the 2005 study authored
by Bradford Scott?
Correct Answer
A. Because of AlloDerm’s ability to be used in a contaminated field
Explanation
AlloDerm was chosen as the biological mesh in the 2005 study authored by Bradford Scott because of its ability to be used in a contaminated field. This suggests that AlloDerm is effective in situations where there is a risk of infection or contamination, making it a suitable choice for the study. Additionally, the other options mentioned, such as AlloDerm's ability to stretch significantly and its longevity in the market, may also be true but are not specifically mentioned as the reasons for its selection in the study.