P-007 CYANOACRYLATE IS A USEFUL TOOL TO PREVENT SEROMAS IN INCISIONAL HERNIA SURGERY

Abstract

Abstract Aim To demonstrate that the use of cyanoacrylate (Glubran®) can decrease the incidence of postoperative surgical site occurrences (SSO) in incisional hernia (IH) surgery. Methods Retrospective cohort analysis of SSO after elective IH repairs (November 2018 to October 2020). Group 1: mesh fixation by interrupted stitches associating cyanoacrylate (as well as spreading it in subcutaneous tissue). Group 2: without cyanoacrylate. Results 113 patients were analyzed included (females: 50.4%, age: 70 (IQR: 59–75years)). Length of stay: 3 (IQR: 2–6days). Comorbidities: diabetes (7.1%), hypertension(29.2%), dyslipidemia(41%), smoking(38.1%), alcohol consumption(22.1%), cardiovascular disease(15.9%). ASA: I(5.3%), II(62.8%), III(31.9%). BMI: 29.14±3.63kg/m2. Hernia location: midline (89.4%), others (10.6%). Cyanoacrylate group:54.9%. Surgical technique: onlay (61.1%), sublay (38.9%). Postoperative complications: global (29.2%), clinical seroma (25.7%), ultrasound seroma (32.7%). Surgical site infection-SSI (8.8%). Recurrence: 3.5%. Patients with cyanoacrylate had lower overall complications, clinical and ultrasound seroma and SSI rates (17.7% vs 43.1% p=0.003; 16.1% vs 37.3% p=0.011; 27.4% vs 39.2% p=0.1; 3.2% vs 15.7% p=0.02 respectively). These findings are even more statistically significant after selecting onlay procedures (23.3% vs 51.3% p=0.018; 16.7% vs 46.2% p=0.01; 30% vs 46.2% p=0.1; 6.7% vs 20.5% p=0.04 respectively). These differences were maintained in the multivariate analysis (p <0.05). Conclusion The cyanoacrylate (Glubran®) is a good tool in preventing postoperative seromas in patients with IH (particularly in onlay procedures), without increasing the incidence of other complications.