Truss (medicine)

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Truss pad. A Reference handbook of the medical sciences - embracing the entire range of scientific and practical medicine and allied science (1885) (14597569749).jpg
Truss pad.

In medicine, a truss is a kind of surgical appliance, particularly one used for hernia patients. A truss provides support for the herniated area, using a pad and belt arrangement to hold it in the correct position, just when it is put on before moving from bed.

Of historical interest, a variety of trusses are listed in the Snowden & Brother's catalog of the American Civil War era. [1]

Early versions of the hernia truss were daunting contraptions made from leather and steel with metal springs. The 19th century Eggleston's Truss from Chicago was described as follows:

"Eggleston's Truss has a pad different from all others. It is cup-shaped, with a self-adjusting ball in the centre, and adapts itself to all positions of the body, while the ball in the cup presses back the intestines just as a person does with the finger. With light pressure the hernia is held securely day and night, and a radical cure is certain. It is easy, durable and cheap." [2]

Later developments resulted in the Cluthe truss, described in Cluthe's Advice to the Ruptured, [3] first published in 1912. This book also describes dozens of hernia cases which appeared to be cured by this relatively primitive truss. Such testimonials are no longer considered to be scientific evidence.

Currently most doctors and surgeons do not prescribe trusses. Even some of today's trusses use metal springs to apply pressure to the hernia, via a pad which can be quite hard, and usually bulges into the hernia. This inward bulging prevents the edges of the hernia from coming together and could, in theory, enlarge the hernia. Many trusses also do not fit well. It is difficult to design a truss which keeps the pad permanently in contact with the hernia. Unless a truss can achieve this purpose, the hernia may continue to enlarge.[ citation needed ]

External devices such as a truss to maintain reduction of the hernia without repairing the underlying defect can be used to avoid surgical risks, mainly chronic pain risk.[ citation needed ]

Related Research Articles

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A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Various types of hernias can occur, most commonly involving the abdomen, and specifically the groin. Groin hernias are most commonly of the inguinal type but may also be femoral. Other types of hernias include hiatus, incisional, and umbilical hernias. Symptoms are present in about 66% of people with groin hernias. This may include pain or discomfort in the lower abdomen, especially with coughing, exercise, or urinating or defecating. Often, it gets worse throughout the day and improves when lying down. A bulge may appear at the site of hernia, that becomes larger when bending down. Groin hernias occur more often on the right than left side. The main concern is bowel strangulation, where the blood supply to part of the bowel is blocked. This usually produces severe pain and tenderness in the area. Hiatus, or hiatal hernias often result in heartburn but may also cause chest pain or pain while eating.

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Hiatal hernia Type of hernia

A hiatal hernia or hiatus hernia is a type of hernia in which abdominal organs slip through the diaphragm into the middle compartment of the chest. This may result in gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) with symptoms such as a taste of acid in the back of the mouth or heartburn. Other symptoms may include trouble swallowing and chest pains. Complications may include iron deficiency anemia, volvulus, or bowel obstruction.

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Aortic aneurysm Notable enlargement of the aorta (heart artery)

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Hydrocele Medical condition

A hydrocele is an accumulation of serous fluid in a body cavity. A hydrocele testis is the accumulation of fluids around a testicle. It is often caused by fluid collecting within a layer wrapped around the testicle, called the tunica vaginalis, which is derived from peritoneum. Provided there is no hernia present, it goes away without treatment in the first year. Although hydroceles usually develop in males, rare instances have been described in females.

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Hematocele Medical condition

A hematocele is a collections of blood in a body cavity or potential space. The term most commonly refers to the collection of blood in the tunica vaginalis around the testes, known as a scrotal hematocele. Hematoceles can also occur in the abdominal cavity and other body cavities. Hematoceles are rare, making them harder to diagnose and treat. They are very common especially as slowly growing masses in the scrotum usually in men older than 50 years.

Umbilical hernia Medical condition

An umbilical hernia is a health condition where the abdominal wall behind the navel is damaged. It may cause the navel to bulge outwards—the bulge consisting of abdominal fat from the greater omentum or occasionally parts of the small intestine. The bulge can often be pressed back through the hole in the abdominal wall, and may "pop out" when coughing or otherwise acting to increase intra-abdominal pressure. Treatment is surgical, and surgery may be performed for cosmetic as well as health-related reasons.

Spigelian hernia Surgical condition

A Spigelian is the type of ventral hernia where aponeurotic fascia pushes through a hole in the junction of the linea semilunaris and the arcuate line creating a bulge. It appears in the abdomen lower quadrant between an area of dense fibrous tissue and abdominal wall muscles causing a.

Femoral hernias occur just below the inguinal ligament, when abdominal contents pass through a naturally occurring weakness in the abdominal wall called the femoral canal. Femoral hernias are a relatively uncommon type, accounting for only 3% of all hernias. While femoral hernias can occur in both males and females, almost all develop in women due to the increased width of the female pelvis. Femoral hernias are more common in adults than in children. Those that do occur in children are more likely to be associated with a connective tissue disorder or with conditions that increase intra-abdominal pressure. Seventy percent of pediatric cases of femoral hernias occur in infants under the age of one.

An incisional hernia is a type of hernia caused by an incompletely-healed surgical wound. Since median incisions in the abdomen are frequent for abdominal exploratory surgery, ventral incisional hernias are often also classified as ventral hernias due to their location. Not all ventral hernias are from incisions, as some may be caused by other trauma or congenital problems.

Diaphragmatic rupture Tear in the thoracic diaphragm, usually caused by physical trauma

Diaphragmatic rupture is a tear of the diaphragm, the muscle across the bottom of the ribcage that plays a crucial role in breathing. Most commonly, acquired diaphragmatic tears result from physical trauma. Diaphragmatic rupture can result from blunt or penetrating trauma and occurs in about 0.5% of all people with trauma.

In medicine, Carnett's sign is a finding on clinical examination in which (acute) abdominal pain remains unchanged or increases when the muscles of the abdominal wall are tensed. For this part of the abdominal examination, the patient can be asked to lift the head and shoulders from the examination table to tense the abdominal muscles. An alternative is to ask the patient to raise both legs with straight knees.

Familial aortic dissection Medical condition

Familial aortic dissection or FAD refers to the splitting of the wall of the aorta in either the arch, ascending or descending portions. FAD is thought to be passed down as an autosomal dominant disease and once inherited will result in dissection of the aorta, and dissecting aneurysm of the aorta, or rarely aortic or arterial dilation at a young age. Dissection refers to the actual tearing open of the aorta. However, the exact gene(s) involved has not yet been identified. It can occur in the absence of clinical features of Marfan syndrome and of systemic hypertension. Over time this weakness, along with systolic pressure, results in a tear in the aortic intima layer thus allowing blood to enter between the layers of tissue and cause further tearing. Eventually complete rupture of the aorta occurs and the pleural cavity fills with blood. Warning signs include chest pain, ischemia, and hemorrhaging in the chest cavity. This condition, unless found and treated early, usually results in death. Immediate surgery is the best treatment in most cases. FAD is not to be confused with PAU and IMH, both of which present in ways similar to that of familial aortic dissection.

Inguinal hernia surgery Medical procedure

Inguinal hernia surgery is an operation to repair a weakness in the abdominal wall that abnormally allows abdominal contents to slip into a narrow tube called the inguinal canal in the groin region.

References

  1. Snowden; Weiss, John (1997). Surgical and Dental Instruments Catalogues from the Civil War Era. Norman Publishing. ISBN   978-0-930405-72-4. Archived from the original on 2020-11-30. Retrieved 2008-04-20.
  2. Scientific American Vol 40 No. 13 March 1879
  3. Chas. Cluthe & Sons (1912). Cluthe's Advice to the Ruptured. Bloomfield, New Jersey: CLUTHE RUPTURE INSTITUTE.