Repair of large incisional hernias. To drain or not to drain. Randomized clinical trial

• Published in: Acta cirurgica brasileira Vol. 30; no. 12; pp. 844 - 851
• Main Authors: Westphalen, André Pereira, Araújo, Allan Cézar Faria, Zacharias, Patrícia, Rodrigues, Eduardo Silva, Fracaro, Geanine Baggio, Lopes Filho, Gaspar de Jesus
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia 01-12-2015
• Subjects: Adult; Aged; Drainage; Drainage - adverse effects; Drainage - methods; Female; Follow-Up Studies; Hernia; Hernia, Ventral - surgery; Herniorrhaphy; Herniorrhaphy - rehabilitation; Humans; Incisional Hernia - complications; Incisional Hernia - surgery; Male; Middle Aged; Reoperation; Seroma - diagnostic imaging; Seroma - etiology; Surgical Mesh - adverse effects; Surgical Wound Infection - etiology; Suture Techniques; Suture Techniques - adverse effects; Ultrasonography; Ventral. Seroma
• ISSN: 0102-8650; 1678-2674; 0102-8650
• DOI: 10.1590/S0102-865020150120000009

To evaluate the occurrence of seroma and surgical wound infection after surgery.
A total of 42 individuals with large incisional hernias were subjected toonlay mesh repair. Following the mesh placement, the participants were randomly allocated to two groups. In group 1, closed-suction drains were placed in the subcutaneous tissue, while progressive tension sutures were performed in group 2. The participants were subjected to clinical and ultrasound assessment to detect seroma and surgical wound infection at three time-points after surgery.
The occurrence of seroma at the early, intermediate or late assessments was respectively 19.0%, 47.6%, 52.4% in group 1 and 28.6%, 57.1%, 42.9% in group 2 and was not significantly different between groups (p 0.469; 0.631; 0.619). Surgical wound infection occurred 19% in group 1 and 23.8% in group 2, without a significant difference between the groups (p>0.999).
The frequency of seroma and infection did not exhibit significant differences between individuals subjected to onlay mesh repair of large incisional hernias with drains or progressive tension sutures without drainage.