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War Surgery and Medicine

Recommendations for the Future

Recommendations for the Future

In the light of New Zealand's experience in the 1939–45 War one would recommend:


All young and otherwise fit recruits with primary hernia conditions should be operated on by a competent surgeon as they will be rendered fit for front-line service.

page 417

All patients should have physical exercises to improve the abdominal musculature both before and after operation.


A period of three months should be laid down as necessary for convalescence following operation before posting to the army or return to full duty.


In the older age groups all men with good abdominal musculature in whom satisfactory repair can be carried out should be operated on and given an extra period of three months on light duty before posting or return to full duty.


Cases with feeble abdominal musculature, especially in the older group, and recurrent cases, should not be accepted in the army. If already in the army they should not be operated on but graded for base duties or discharged according to their usefulness to the army.


In the young men with good abdominal musculature the adequate removal of the sac should give a satisfactory result.


There are no data available to show that any of the numerous methods of strengthening the inguinal canal can be deemed to be superior to others or able to give assurance against recurrence. However, many of the methods are of value when used intelligently.


Repair by fascial grafts is satisfactory in the more severe types of hernia, but is liable to more severe disturbance in the presence of sepsis, and again, does not give a guarantee against recurrence.


Repair by silk darning was found unsuitable for use in the army owing to the severe disturbance associated with infection when that did occur.


The operation for hernia is one of considerable importance in the saving of manpower in the army. It demands ability and experience in the operator and should be looked upon as an operation calling for the employment of differing techniques according to the variation in the condition of the individual hernia, and not for a stereotyped routine procedure.