Drain or not After Repair of Ventral Hernia with Mesh

Abstract

Background: Abdominal wall hernias are among the most common of all surgical problems. Ventral hernia repair (VHR) is a commonly performed operation, so hernia defect size affects operative time and surgical technique for repair of a ventral hernia. Incisional hernia is the most frequent postoperative complication following general surgery. Objectives: This study was done to review and assess the difference between insertion of wound drain and the use of abdominal binder and percutaneous aspiration after open repair of ventral hernias and its effect on postoperative outcome. Patients and methods: A total of 100 patients with non-complicated abdominal wall (ventral) hernia were enrolled to review and assess the difference between insertion of wound drain and the use of abdominal binder and percutaneous aspiration after open repair of ventral hernias and its effect on postoperative outcome. Patients were divided into two groups: Group (A) includes 50 patients with insertion of wound drain. Group (B) includes 50 patients with application of abdominal binder immediately postoperatively for 2 weeks. Results: This study showed distribution of patients according to age, ranging from 27 years to 70 years with mean age of 49.2 years (±11.6 years). 25% of patients below 39, 50% of patients below 50 and 75% of patients below 59.75. In our study, 60% of operations were carried out under spinal anesthesia and 40% of operations were carried out under general anesthesia. The hernial content of 100 patients was intestine in 28 cases, and omentum in 72 cases. There were developing of significant seroma in (30%) of patients as follow: (17%) at group A (with drain) and (13%) at group B (without drain). Significant seroma was not seen in (70%) of patients. Wound infection was developed in (18%) of patients as follow; (12%) for group A (with drain) and (6%) for group B (without drain). Wound infection not seen in (82%) of patients. As regard recurrence, (2%) of total count only showing early recurrence that present at group B. Of total count only (9%) complained of persistent postoperative pain as follows, 6 cases from group (A) and 3 cases from group (B). Conclusion: It could be concluded that combined abdominal binder and percutaneous aspiration for selected cases were superior to insertion of wound drains as regards seroma formation, wound infection and postoperative return to normal activity with no significant difference as regards hematoma, postoperative pain, hospital stay and patient satisfaction.