Abstract
PurposeInguinal hernia is a common male surgical disease. Intervention carries a wide range of complications such as scrotal haematoma and seroma which may require surgical re-intervention or predispose patients to developing infections, pains or feeling of mass. This could lead to long hospital stay. Scrotal tamponade by bandaging or wearing of tight pants and elevation are practiced to reduce bleeding and haematoma formation. These methods require prolong use. Closed suction drains are scarcely used in resource-deprived communities due to high cost and non-availability.AimThis study was to determine the effectiveness of a closed non-suction drain in preventing scrotal collection requiring further surgical intervention and the predisposition to developing surgical site infection following nylon darn repair of inguinoscrotal hernia.MethodsForty (40) participants were recruited for a preliminary study and assigned into control and interventional groups (CG, IG) for purposes of inserting flexible feeding tube (FFT) wound drain after nylon darn (ND) repair. Daily measurement of drained scrotal collection was carried out in the IG till the day drainage was zero. Residual volumes in IG and wound collection in the CG who were not candidates for re-intervention were determined at 14th and 28th post-operative days using ultrasound scan. Data were analyzed using SPSS version 25.ResultsThree (3) patients (15.8%) in the CG required re-intervention. Surgical site infection rates for the CG and IG were, respectively, 2/19 versus 0/21 (ρ = 0.134).There was a numerical significant difference in the mean volumes of scrotal collections between the control (0.95 ± 0.42 ml) and the intervention group (0.44 ± 0.33 ml) [p value of 0.041] but with no clinical impact.ConclusionSimple inexpensive flexible feeding tube placement significantly reduced scrotal collection which forms a base for larger sample size in subsequent studies. This could reduce the feared risk of re-intervention, wound infection and long hospital stay post-operative.
Highlights
Inguinal hernia (IH) is a common surgical condition which affects males predominantly [1] with a prevalence ranging from 3.15 to 9.4% in Africa [2, 3]
For the period 2015–2019, 60 (9.3%) out of the 643 IH cases managed at Margret Marquart Catholic Hospital (MMCH) presented with intestinal complications
The diagnosis of complete inguinoscrotal hernia was made preoperatively through clinical assessment and confirmed intra-operatively by an existing sac which was completely separated from the spermatic cord structures as described by BAJA [12]
Summary
Inguinal hernia (IH) is a common surgical condition which affects males predominantly [1] with a prevalence ranging from 3.15 to 9.4% in Africa [2, 3]. For the period 2015–2019, 60 (9.3%) out of the 643 IH cases managed at Margret Marquart Catholic Hospital (MMCH) presented with intestinal complications. Nylon darn is an example of a tissue-based repair technique for IH. It is a tension-free approximation of the inguinal ligament to the conjoint tendon with nylon suture from the pubic tubercle to the internal ring. This weave in the posterior wall of the inguinal canal was first described by Moloney. This method was chosen based on competence, cost effectiveness and its relative good potential to withstand surgical site infection [7]
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