Online ISSN: 2515-8260

Keywords : Seroma


A comparative study of onlay and pre-peritoneal open mesh repair in the management of umbilical hernia in adults

Dr. Sreekaraswamy R, Dr. HC Chaluvanarayana, Dr. Sujay C, Dr. Varun Byrappa

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1655-1659

Introduction: Umbilical hernias in adults are commonly acquired hernias. These are more common in women, and in conditions like pregnancy, ascites, obesity etc. More than 1 million hernia surgeries are done annually in India. Suture repair techniques have dominated ventral and incisional hernia repair over a century. The most popular of these techniques was the Mayo duplication. In larger hernias, suture repair requires the application of tension to the fascia in order to close the orifice.
Objectives of the study: To evaluate the outcome of onlay and pre-peritoneal open mesh repair in umbilical hernias in adults regarding operative time, ease of procedure, hospital stay, complications and recurrence if any.

Factors Affecting Seroma Formation after Modified Radical Mastectomy in Patients of Carcinoma Breast: A Prospective Study

Rohit Kumar Soni, Milan Kumar Khatri, Meenakshi Suhalka, Rakesh Kumar Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10507-10513

Introduction: Seroma formation is the most common complication after breast cancer
surgery, especially when axillary dissection is performed.
Aim: This study intends to find out the association between certain pre-operative, intraoperative,
and post-operative factors related to MRM and incidence of seroma
formation.
Methods: A total of 50 patients with Ca breast undergoing breast surgery were
admitted in surgical wards at tertiary carehospital.
Results: The cumulative total seroma volume collected by the end of treatment was
higher and the overall time of seroma treatment was longer in patients over the age of
60 years (60.89±9.17 vs 55.25±10.05years p<0.001) and more obese (BMI, 26.78±5.2
versus 24.86±3.91; p<0.001). Higher amount of initialdrain volume was directly related
to seroma formation.The incidence is decreased byearly initiation of arm physiotherapy
after surgery (3.21±0.91 days versus 2.08±0.76 days; p=0.0001).
Conclusion: The incidence of seroma is higher in older, obese patients and higher drain
output. The incidence is decreased by early physiotherapy. Interventions in the
operative period reduce the seroma formation.

EFFECTIVENESS OF MESH VS ANATOMIC REPAIR IN MANAGEMENT OF PARAUMBILICAL HERNIAS – A COMPARATIVE STUDY

Sridhar Matta, Janardhan Jakkula, M. Praveen, Ch. Santosh Babu

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11574-11593

Background:The purpose of the study is to determine the appropriate mode of managing paraumbilical hernias in terms of complications and recurrences.
Materials and Methods: In this clinical study, 50 patients with paraumbilical hernia were admitted and underwent surgery subsequently from October 2019 to September 2021. The patients were studied for, clinical features, treatment and postoperative complications. Cases were prepared for surgery after preoperative correction of anemia, hypertension, obesity, diabetes and local skin conditions. All patients underwent surgical procedure after following preoperative preparation.
Results: The present study shows that majority of the patients are in the age group of 40-60years, i.e., between 4th and 6th decades of life (52%). 2 patients are above 70 years. In this study, the patients were categorized into two groups based on the procedure performed in accordance to the size of the defect: Both anatomical and prosthetic mesh repair was performed across all defect sizes and the outcomes compared. Among 28 patients with a defect size of 2-5cms, anatomical repair was performed in 18 patients (64.2%), while mesh repair was performed in 10 patients(35.7%). Among 22 patients with a defect size more than 5cms, anatomical repair was performed in 6 patients (27.2%), while mesh repair was performed in 16 patients (72.7%). Skin necrosis, wound infection, seroma and wound dehiscence were noted in this study group. Skin necrosis was seen in 2 patients (8.3%) in anatomical repair group, while 1 patient (3.8%) developed in prosthetic mesh repair group. Wound infection was seen in 2 patients (8.3%) in anatomical repair group, while 3 patients(11.5%) developed in prosthetic mesh repair group.  Seroma was seen in 4 patients (16.6%) in anatomical repair group, while 2 patients(7.6%) developed in prosthetic mesh repair group. In two years of regular follow up, 2 recurrences (8.3%) were noted in the anatomical repair group while no recurrences were noted in the prosthetic mesh repair group. The subjects who underwent anatomical repair  were followed up for a mean period of 14.63 months with a standard deviation of 6.67 and those who underwent prosthetic mesh repair were followed up for a mean period of 13.45 months with a standard deviation of 5.8.
Conclusion: To conclude, it can be said that in the treatment of paraumbilical hernias, prosthetic mesh repair seems superior to anatomical repair, although significant difference could not be demonstrated. Statistical significance between the two procedures probably could be obtained if the sample size and follow up period is increased.

DARNING TECHNIQUE VERSUS MESH (LICHTENSTEIN PROCEDURE) for PRIMARY INGUINAL HERNIA REPAIR

Dr. Mahmood Shakor Mughir; Dr.Hazim Taha Ismael; Dr. Lateef Mohammed Shinawa

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 362-365

The present study was aimed to compare the complications percent in repair of mesh to tension
free repair of Darn. Methods: 127 patients from 20-66 years old, including 93 (73.2%) male and
34 (26.8%) females, reported for direct and indirect inguinal hernia with open
Mesh/Lichtenstein (58 patients) or Darning repair (69 patients) in Khanagin general hospital
and Jalawla general hospital from February 2017 to February 2020. The first point was to
compare hernia recurrence with two types of technique. Results: Complications of recurrence in
Lichtenstein repair were 1 patient (1.7%) with compared to darning repair which had a
recurrence of 3 patients (4.34%). also, 3 patients (4.34%) got seroma in the darning repair
technique while 2 patients (3.45%) in the mesh repair technique. Hematoma was appeared in 1
patient (1.45%) in darning repair group and nil in the mesh/Lichtenstein repair group. 2
patients (2.90%) treated by darning repair suffered from chronic pain while 1 patient (1.7%)
suffered from chronic pain in mesh/Lichtenstein repair group. Conclusion: mesh/Lichtenstein
repair is very promising in comparison to the other technique, darning repair, in complications
in hernia.