Abstract
Seroma Is a collection of fluid called serum that gets collected at the site of inguinal hernia surgery. It is common after inguinal hernia repair with a mesh. Usually seroma develops after 7 to 10 day of operation but can develop even earlier depending upon the amount of tissue dissection. More the dissection more the chances of development of seroma. The fluid in seroma is usually clear or straw colored. Seroma generally does not require any treatment; it disappears by absorption by body tissues within few weeks. Large seromas may require repeated aspiration. To avoid developing seroma after inguinal hernia surgery is to do minimal tissue dissection and avoid dead space formation. We operated 400 cases of inguinal hernia by a modified Lichtenstein tension-free procedure called NICH (Nigam’s inverted curtain hernioplasty) our incidence of development of seroma was 1.5% against international incidence of 7% which is a real low incidence. We have discussed the ways to avoid formation of seroma after open inguinal hernioplasty.
 Keywords: dead space, dissection, inguinal hernia, Lichtenstein, mesh, NICH, seroma.
Highlights
Seroma is a collection of serum at the site of operation
We have operated upon 400 cases of inguinal hernia by modified Lichtenstein’s tension free hernioplasty, called Nigam’s inverted curtain hernioplasty (NICH).[2]
Elastoplasts applies extra pressure over operation sit and helps in preventing dead space formatting and seroma formation. These operative steps in NICH help to reduce the incidence of seroma formation
Summary
Seroma is formed due to tissue dissection and can occur in any patient after groin hernia surgery. Seroma appears like a lump in the groin at the site of surgery. It is a selflimiting problem but sometimes requires several aspirations. In NICH we do minimum tissue dissection, use minimum sutures to fix the mesh, double breasting of external oblique aponeurosis (it applies pressure and removes dead space) and dressings with Elastoplasts, an elastic adhesive tape. Elastoplasts applies extra pressure over operation sit and helps in preventing dead space formatting and seroma formation. These operative steps in NICH help to reduce the incidence of seroma formation
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