Insides Summer

The Permanente Journal / Summer 1999/Volume 3. No. 2 Reprinted from the Permanente Foundation Medical Bulletin 1944;2(3):114-120 In a 21 month period (September, 1942 to May, 1944) 623 hernioplastic procedures (532 patients; 92% inguinal) were performed at the Oakland, CA, Permanente Foundation Hospital, making this the most common major surgical procedure at that facility. Most were considered related to industrial injury; 42 represented recurrent hernias. A modified Halsted technique, under spinal anesthesia (89%), was usually performed. There were no deaths and very few operative complications (3 inadvertent urinary bladder openings). Post-operative minor and major pulmonary complications were common (23%), and not reduced by sulfadiazine prophylaxis. However, there were no pulmonary complications in a small subset of persons ambulated on the first or second postoperative day. This experience illustrates the importance of this condition and of its management.