Laparoscopic Ventral Hernia Repair: Postoperative Antibiotics Decrease Incidence of Seroma-Related Cellulitis

2005 ◽  
Vol 71 (11) ◽  
pp. 931-936 ◽  
Author(s):  
C. Edwards ◽  
J. Angstadt ◽  
O. Whipple ◽  
R. Grau
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Prophylactic Antibiotics ◽  
Seroma Formation ◽  
Laparoscopic Ventral Hernia Repair ◽  
Antibiotic Administration ◽  
Mesh Infection ◽  
Antibiotic Group ◽  
Preoperative Antibiotics

Seroma formation has been documented as a common complication in laparoscopic ventral herniorraphy. However, there are no recent studies documenting the incidence of or protective strategies against seroma-related cellulitis. The purpose of this study was to evaluate 65 laparoscopic ventral herniorraphies and to determine if seroma-related cellulitis can be prevented by the routine use of postoperative prophylactic antibiotics. A retrospective case review of 65 laparoscopic ventral herniorraphies was done at our institution from February 2002 to January 2004. All were performed using either Gore-Tex DualMesh or Bard Composix mesh and performed under the direct supervision of a single surgeon. Twenty patients received only preoperative third-generation cephalosporins or fluoroquinolones. All other patients received either 7 days of postoperative oral cephalosporins or fluoroquinolones in addition to preoperative antibiotics. Sixty-five patients underwent laparoscopic ventral hernia repair. There were 45 patients in the postoperative antibiotic group and 20 patients in the preoperative-only antibiotic group. Twenty-one patients developed seromas. Twelve of these developed cellulitis. The rates of seroma formation were similar in the two groups with 30 per cent in the preoperative only group and 33 per cent in the postoperative antibiotic group. However, 100 per cent of the seromas in the preoperative antibiotic group developed seroma-related cellulitis. Only 40 per cent of seromas in the postoperative antibiotic group developed cellulitis. In addition, two seromas in the preoperative antibiotics–only group progressed to frank mesh infection necessitating operative removal. There were no complications related to antibiotic administration. Laparoscopic ventral hernia repair is a safe and effective procedure. Our seroma rate is 30 per cent and compares equally with prior reported studies. Seroma-related cellulitis is a common problem that can lead to mesh infection, postoperative morbidity, and further need for operative care. The administration of 7 days of postoperative prophylactic antibiotics appears to be a safe and effective means to limit seroma-related cellulitis.

scholarly journals Role of Tranexamic Acid for Seroma Prevention in Obese Patients Undergoing Laparoscopic Ventral Hernia Repair Under Spinal Anesthesia

2021 ◽  
Vol 15 (10) ◽  
pp. 3488-3490
Author(s):  
Rizwan Khan ◽  
Mahabub Aalam ◽  
Naeem Ahmed ◽  
Muddasar Pervaiz ◽  
Zahid Saeed
Keyword(s):  
Body Mass Index ◽  
Hernia Repair ◽  
Tranexamic Acid ◽  
Spinal Anesthesia ◽  
Ventral Hernia ◽  
Body Mass ◽  
Ventral Hernia Repair ◽  
Seroma Formation ◽  
Laparoscopic Ventral Hernia Repair ◽  
Obese Patients

Objective: The aim of this study is to determine the effectiveness of tranexamic acid for seroma prevention in obese patients undergoing laparoscopic ventral hernia repair under spinal anesthesia. Study Design: Cross sectional study Place and Duration: Jinnah Postgraduate Medical Center (JPMC) Karachi, 1st July 2020 to 30th June 2021. Methods: There were one hundred and ten patients f both genders had abdominal hernia were included in this study. We have taken written consent from all the patients for detailed demographics age, sex and body mass index. Patients were undergone for laparoscopic ventral hernia repair under spinal anesthesia in OPD. The size and contents of the defect were determined by an abdominal and pelvic ultrasound. All patients received postoperative tranexamic acid. Drains were put in to measure the amount of seroma that was produced as a result of the procedure. SPSS 22.0 was used to analyze all of the data. Results: 42.23±6.55 years were the mean age of the patients. Mean Body mass index was 32.13±3.43 kg/m2. Majority of the patients 74 (67.3%) were females and rest of the patients 36 (32.7%) were males. In 91 (82.7%) cases seroma reduction was calculated within week. Only 41 of the 110 patients had drain output of less than 150 ml, 55 had drain output of 150-300 ml, and 14 had drain output greater than 300 ml. Seroma formation was found among 7 (6.4%) cases. Conclusion: Tranexamic acid was found to be efficient in minimizing postoperative seroma formation in ventral hernia repairs, according to the findings of this study. Keywords: Laparoscopic, Tranexamic acid, Plasminogen, Seroma, Obese Patients

scholarly journals A comparative study of closure versus non-closure of hernial defect in laparoscopic ventral hernia mesh repair

2019 ◽  
Vol 7 (1) ◽  
pp. 244
Author(s):  
Nandeesh M. ◽  
Akash M. V.
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Mesh Repair ◽  
Ventral Hernia Repair ◽  
Seroma Formation ◽  
Laparoscopic Ventral Hernia Repair ◽  
Controlled Study ◽  
Fisher Exact Test ◽  
Mesh Placement ◽  
Open Mesh Repair

Background: Laparoscopic ventral hernia repair has better out comes when compared to open mesh repair. But closure of the hernial defect is still a contentious issue. This study is designed to compare the outcome of closure versus non-closure of hernia defect in laparoscopic ventral hernia repair.Methods: A 2 years prospective randomized controlled study was conducted on 60 patients undergoing elective laparoscopic ventral hernia repair in the Department of General Surgery (November 2016 to October 2018).Results: The patients in the two groups were analyzed using Chi-square, ANOVA, Fisher exact test, and results were formulated. The mean age of ventral hernia was 41 years and overall incidence more in females. Paraumbilical hernia is the commonest variety of ventral hernia and 63.3% hernias were reducible. Average post-operative length of hospital stay was 2 days with no difference in both the groups. Post-operative pain was more in intraperitoneal onlay mesh (IPOM) plus group. Seroma formation and Incidence of mesh bulge was found be more in IPOM group, but there was no difference in the incidence of chronic pain or recurrence rate between the two groups. All the above proved statistical significance.Conclusions: Primary defect closure in ventral hernia along with mesh placement in laparoscopy seems to have better outcome, with respect to less chance of seroma formation and mesh bulge.

scholarly journals Long term outcome and elasticity of a polyester mesh used for laparoscopic ventral hernia repair

Hernia ◽  
2021 ◽  
Author(s):  
P. J. O’Dwyer ◽  
C. Chew ◽  
H. Qandeel
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Laparoscopic Repair ◽  
Ventral Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair ◽  
Ct Scans ◽  
Unique Problem ◽  
Polyester Mesh

Abstract Background Repair of a ventral hernia is increasingly being performed by a laparoscopic approach despite lack of good long term follow up data on outcomes. The aim of this study was to examine the long term performance of a polyester mesh and to assess its elastic properties in patients undergoing laparoscopic ventral hernia repair. Methods All patients being assessed for a ventral hernia repair between August 2011 and November 2013 were placed on a prospective database. Those undergoing laparoscopic repair with a polyester mesh were seen at clinic at one month and one year, while their electronic records were assessed at 34 months (range 24–48 months) and 104 months (range 92–116 months). In addition, CT scans of the abdomen and pelvis performed for any reason on these patients during the follow up period were reviewed by a consultant gastrointestinal radiologist. Mechanical failure testing of the mesh was also performed. Results Thirty-two of the 100 patients assessed for ventral hernia repair had a laparoscopic repair with a polyester mesh. Nineteen (59%) had CT scans performed during the follow-up period. No recurrence was recorded at 34 months, while three (9.4%) had a recurrence at 104 months. Two had central breakdown of the mesh at 81 and 90 months, while 1 presented acutely at 116 months after operation. Mesh had stretched across the defect by an average of 21% (range 5.7–40%) in nine patients. Mechanical testing showed that this mesh lost its elasticity at low forces ranging between 1.8 and 3.2 N/cm. Conclusion This study shows that late recurrence is a problem following laparoscopic ventral hernia repair with polyester mesh. The mesh loses it elasticity at a low force. This combined with degradation of mesh seems the most likely cause of failure. This is unlikely to be a unique problem of polyester mesh and further long-term studies are required to better assess this operative approach to ventral hernia repair.

Prevention of Subcutaneous Seroma Formation in Open Ventral Hernia Repair Using a New Low-Thrombin Fibrin Sealant

2014 ◽  
Vol 38 (11) ◽  
pp. 2797-2803 ◽  
Author(s):  
Gernot Köhler ◽  
Oliver Owen Koch ◽  
Stavros A. Antoniou ◽  
Michael Lechner ◽  
Franz Mayer ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Fibrin Sealant ◽  
Ventral Hernia Repair ◽  
Seroma Formation ◽  
Open Ventral Hernia Repair
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