PREVENTION OF SEROMA FORMATION AFTER OPEN VENTRAL HERNIA REPAIR WITH MASSIVE SKIN AND SUBCUTANEOUS RECONSTRUCTION: A RANDOMIZED CLINICAL TRIAL | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 33, Issue 1, January 2014, Page 54-59 PDF (703.7 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2014.366644 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Osama M. H. Khalil* ; Wael M. Abdalla; Zaki A. Allam; Osama A. Eltih | ||||
| Department of Surgery, Faculty of Medicine, Zagazig University, Egypt | ||||
| Abstract | ||||
| Introduction: Seroma and wound breakdown are commonest post-operative complication after open ventral hernia repair with massive skin and subcutaneous reconstruction. Following open ventral hernia, these occur in 12-20% and increase to 17-34% when combined with massive skin and subcutaneous reconstruction. This study evaluates a novel technique of applying talc powder to subcutaneous flaps to prevent seroma formation. Patients and Methods: Sixty one patients of ventral hernia with skin and subcutaneous reconstruction were admitted to surgery department in Zagazig University Hospital. They were randomly divided into two groups .The PRE group did not receive talc therapy, and the POST group received talc therapy in the subcutaneous dissection. A prospectively collected surgical outcomes database was accessed identifying all patients. Demographics, peri-operative data, and outcomes were analyzed. Results: PRE group consisted of 31 patients and POST group consisted of 30 patients. Complication rates for PRE/ POST goups were: cellulitis or oral antibiotics 35.5%-13.3%, intravenous antibiotics 9.7%-3.3%, operative/radiologic intervention for wound infection 19.4%-13.3%, seroma intervention 19.4%-3.3%, wound breakdown12.9%- 3.3% and hernia recurrence 9.7 %- 0%. Of these, seroma intervention and hernia recurrence were significantly decreased in the POST group (p0.013, p0.032). Mean drain duration was 27.4 days for PRE and 16.3 days for POST (p0.004). Mean follow-up was 5.6 months for PRE and 2.5 months for POST (p0.032). Conclusion: The addition of talc powder made a dramatic difference in patient outcomes. We found a decreased percentage of wound complications, with a significant reduction in seroma formation, recurrence, and drain duration. The use of talc powder is simple and easy for high risk patients to avoid post-operative complications especially seroma and wound break. | ||||
| Keywords | ||||
| seroma; ventral hernia; Talc powder | ||||
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