. Diseases of children. dominal binder is to hold a small compress over this stillunclosed umbilicus. As the child grows very rapidly at this period,the tissues fill up this unclosed portion, and it soon becomes the infant is premature, frail, or badly nourished, closure may nottake place; this is more common in girl infants. Severe crying,coughing, or marked abdominal distention also has a tendency to UMBILICAL HEUNIA 91 prevent closure, as does traction of tJie umbilical cord. The co\crii)gsof the bowel in the hernia are skin, transverse fascia, and peritoneum. Symptoms.—This f
. Diseases of children. dominal binder is to hold a small compress over this stillunclosed umbilicus. As the child grows very rapidly at this period,the tissues fill up this unclosed portion, and it soon becomes the infant is premature, frail, or badly nourished, closure may nottake place; this is more common in girl infants. Severe crying,coughing, or marked abdominal distention also has a tendency to UMBILICAL HEUNIA 91 prevent closure, as does traction of tJie umbilical cord. The co\crii)gsof the bowel in the hernia are skin, transverse fascia, and peritoneum. Symptoms.—This form of hernia rarely produces any may, however, gradually increase in size, especially if constipation,cough, and much abdominal distention are present, and is often muchincreased later in life by pregnancy. Treatment.—Prophylaxis embraces the wearing of a snug, but nottight, abdominal binder, with a small retaining pad over the should be worn at least during the first two months, or longer if. Fig. 13.—Adhesive plaster applied for umbilical hernia. necessarv. As soon as the hernia is discovered, it should be returnedwithin the abdominal cavity and retained by doubling in over theumbilicus two longitudinal folds of tissue, one from either side of theabdominal wall and on opposite sides of the umbilicus, and folds in place with two broad strips of zinc oxide adhesive properly applied, these strips will remain in position for some days,and will produce very little irritation of the skin. They should extendfrom one side of the outer abdominal wall across to the other, that is,about half way around the childs body (Fig. 13), and this method 92 COXGEXITAL MALFORMATIOXS of treatment should be eontinuetl for two or three mouths, or longer ifthe hernia persists. It is mueh more liable to result in a cure than theapplication of the ordinary umbilical truss with a conical projectionwhich fits into the opening and really tends to pre
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