Application of Subcutaneous Talc in Hernia Repair and Wide Subcutaneous Dissection Dramatically Reduces Seroma Formation and Post-Operative Wound Complications

Aim: To compare Desarda’s versus Lichtenstein’s mesh repair in patients with unilateral, primary, reducible inguinal hernia in terms of mean operative time and seroma formation Methods: This randomized control trial conducted at Department of Surgery, Patuakhali Medical College & Hospital, Patuakhali. Eighty patients with unilateral, primary, reducible inguinal hernia were randomly distributed into two groups to undergo hernia repair i.e. Lichtenstein (L) and Desarda’s (D). Outcome was measured in terms of mean operative time and seroma formation. Seroma formation was defined as presence of enclosed cavity containing serous fluid determined by ultrasonography at 30th post-operative day. Results: Thirty three patients (41.25%) were above 50 years of age, whereas remaining 47 patients (58.75%) were below 50 years of age. Five patients (6.25%) were female and 75 patients(93.75%) were male. Seroma formation was 5% in Desarda’s group while 7.5% in Lichtenstein group (P> 0.05). Similarly difference in mean operative time was statistically non-significant. Seroma formation was common in older age group. There was no effect of smoking, obesity, operative time and gender on seroma formation. Conclusion: It is concluded that there is no difference in frequency of seroma formation and mean operative time in Desarda’s or Lichtenstein’s technique of hernia repair. Journal of Surgical Sciences (2018) Vol. 22 (2) : 99-103

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

World Journal of Surgery ◽

10.1007/s00268-014-2691-z ◽

2014 ◽

Vol 38 (11) ◽

pp. 2797-2803 ◽

Cited By ~ 13

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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Abdominal Wound Problem after Hysterectomy using Scalpel Versus Electrocautery for Skin and Subcutaneous Dissection

10.53350/pjmhs211592870 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2870-2872

Author(s):

Erum Memon ◽

Kiran Batool ◽

Mubashra Samina ◽

Sana Ashfaq ◽

Kaniz Zehra Naqvi

Keyword(s):

Subcutaneous Tissue ◽

Abdominal Hysterectomy ◽

Skin Incision ◽

Wound Complications ◽

P Value ◽

Abdominal Wound ◽

Wound Infections ◽

Tissue Dissection ◽

Wound Problem ◽

Operative Wound

Objective: To evaluate the postoperative abdominal wound problem after hysterectomy with scalpel versus electrocautery for skin and subcutaneous dissection. Material and Methods: A total of 516 post-menopausal women having age 40 to 65 years who were planned for elective hysterectomy were included in this study. Patients having only benign disorders were included. In group E (N=258); Skin incision and tissue dissection was done using electrocautery by setting the electrocautery machine at cutting mode at 30 to 50 watts’ power. In group S (N=258); conventional scalpel was used for skin incision. Scalpel number 23 was used for skin and subcutaneous tissue dissection. Post-operative wound complications such as seroma, hematoma, wound dehiscence and wound infections were primary study endpoints. Results: Mean age was 48.6±6.9 years in electrocautery and 49.2±6.3 years in scalpel group (p-value 0.30). Seroma formation was diagnosed in 98 (37.98%) patients in electrocautery group and in 52 (20.1%) patients in scalpel group (p-value <0.0001). Wound infections were diagnosed in 50 (19.3%) patients in electrocautery group versus in 87 (33.7%) patients in scalpel group (p-value 0.0002). Hematoma was diagnosed in 10 (3.87%) patients in electrocautery group and in 19 (7.4%) in scalpel group (p-value 0.08). Conclusion: The use of electrocautery is associated with lower rate of post-operative wound infections and hematoma formation. The present study advocates the use of electrocautery for skin and subcutaneous tissue dissection in patients undergoing abdominal hysterectomy. Keywords: Abdominal hysterectomy, electrocautery, scalpel, wound complications.

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Wound Complications after Hernia Repair in Patients with Ascites: an Analysis of the ACS-NSQIP Database

Journal of Surgical Research ◽

10.1016/j.jss.2013.11.764 ◽

2014 ◽

Vol 186 (2) ◽

pp. 673

Author(s):

B.R. Englum ◽

P.J. Speicher ◽

A.M. Ganapathi ◽

J.E. Scarborough

Keyword(s):

Hernia Repair ◽

Wound Complications ◽

Acs Nsqip ◽

Acs Nsqip Database

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The impact of 3D conformal radiotherapy versus intensity-modulated radiotherapy on post-operative wound complications in soft tissue sarcomas of the extremity and chest-wall

Journal of Radiation Oncology ◽

10.1007/s13566-016-0277-0 ◽

2016 ◽

Vol 5 (4) ◽

pp. 389-394 ◽

Cited By ~ 2

Author(s):

Hina Saeed ◽

Candice Johnstone ◽

David M. King ◽

John Charlson ◽

Donald A. Hackbarth ◽

...

Keyword(s):

Soft Tissue ◽

Chest Wall ◽

Soft Tissue Sarcomas ◽

Intensity Modulated Radiotherapy ◽

Conformal Radiotherapy ◽

Wound Complications ◽

Intensity Modulated ◽

3D Conformal Radiotherapy ◽

The Impact ◽

Operative Wound

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Impact of Modifiable Comorbidities on Wound Complications after Ventral Hernia Repair

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2018.08.372 ◽

2018 ◽

Vol 227 (4) ◽

pp. e136

Author(s):

Hemasat Alkhatib ◽

Luciano Tastaldi ◽

Clayton C. Petro ◽

Dominykas Burneikis ◽

David Krpata ◽

...

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Wound Complications

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National Outcomes for Open Ventral Hernia Repair Techniques in Complex Abdominal Wall Reconstruction

The American Surgeon ◽

10.1177/000313481508100815 ◽

2015 ◽

Vol 81 (8) ◽

pp. 778-785 ◽

Cited By ~ 13

Author(s):

Samuel W. Ross ◽

Bindhu Oommen ◽

Ciara Huntington ◽

Amanda L. Walters ◽

Amy E. Lincourt ◽

...

Keyword(s):

Length Of Stay ◽

Hernia Repair ◽

Ventral Hernia ◽

Multivariate Regression ◽

Ventral Hernia Repair ◽

Abdominal Wall Reconstruction ◽

Wound Complications ◽

Improvement Program ◽

Major Complications ◽

Open Ventral Hernia Repair

Modern adjuncts to complex, open ventral hernia repair often include component separation (CS) and/or panniculectomy (PAN). This study examines nationwide data to determine how these techniques impact postoperative complications. The National Surgical Quality Improvement Program database was queried from 2005 to 2013 for inpatient, elective open ventral hernia repairs (OVHR). Cases were grouped by the need for and type of concomitant advancement flaps: OVHR alone (OVHRA), OVHR with CS, OVHR with panniculectomy (PAN), or both CS and PAN (BOTH). Multivariate regression to control for confounding factors was conducted. There were 58,845 OVHR: 51,494 OVHRA, 5,357 CS, 1,617 PAN, and 377 BOTH. Wound complications (OVHRA 8.2%, CS 12.8%, PAN 14.4%, BOTH 17.5%), general complications (15.2%, 24.9%, 25.2%, 31.6%), and major complications (6.9%, 11.4%, 7.2%, 13.5%) were different between groups ( P < 0.0001). There was no difference in mortality. Multivariate regression showed CS had higher odds of wound [odds ratio (OR) 1.7, 95% confidence interval (CI) 1.5–2.0], general (OR 1.5, 95% CI: 1.3–1.8), and major complications (OR 2.1, 95%, CI: 1.8–2.4), and longer length of stay by 2.3 days. PAN had higher odds of wound (OR 1.5, 95%, CI: 1.3–1.8) and general complications (OR 1.7, 95% CI: 1.5–2.0). Both CS and PAN had higher odds of wound (OR 2.2,95%, CI: 1.5–3.2), general (OR 2.5, 95%, CI: 1.8–3.4), and major complications (OR 2.2, 95%CI: 1.4–3.4), and two days longer length of stay. In conclusion, patients undergoing OVHR that require CS or PAN have a higher independent risk of complications, which increases when the procedures are combined.

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