Abstract
Purpose
The aim of this study was to evaluate using quilting sutures in a prospective randomized controlled manner the decrease in the incidence of seroma formation among patients subjected to ventral hernia repair.
Methods
The study was a prospective randomized controlled study. 370 patients with large ventral hernias were randomly distributed among two groups. Group A (control group) included 180 patients in whom the repair was done without quilting sutures. Group B (quilting group) included 190 patients, all performed with quilting. Method of dissection was unified as far as possible. All cases had an attached closed suction drain that was removed after two successive days of output ≤ 50 cc. The output of the suction drain was recorded; accumulation of clinically detected seroma after 1, 2 and 4 weeks of removal of the drain was monitored.
Results
There was no statistical difference between both groups as regards the demographic data and the hernia characteristics. There was significantly smaller amount of output of the drains in every day of the first five postoperative days as well as the total amount of the output before drain removal in favor of the quilting group. Drains were removed earlier in group B. The incidence of clinically detected seroma was less in group B as well.
Conclusions
Quilting sutures is an effective and easy technique to reduce post-ventral hernia seroma accumulation.
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References
Shermak MA, Rotellini-Coltvet LA, Chang D (2008) Seroma development following body contouring surgery for massive weight loss: patient risk factors and treatment strategies. Plast Reconstr Surg 122(1):280–288
Dayton MT (2004) Surgical complications. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL (eds) Sabiston textbook of surgery: the biological basis of modern surgical practice, 17th edn. Saunders, Philadelphia, pp 297–332
Lehr SC, Schuricht AL (2001) A minimally invasive approach for treating postoperative seromas after incisional hernia repair. J Soc Laparoendosc Surg 5(3):267–271
Morales-Conde S (2012) A new classification for seroma after laparoscopic ventral hernia repair. Hernia 16(3):261–267
Janis JE, Khansa L, Khansa I (2016) Strategies for postoperative seroma prevention: a systematic review. Plast Reconstr Surg 138(1):240–252
Klima DA, Belyansky I, Tsirline VB, Lincourt AE, Lipford EH, Getz SB et al (2012) Application of subcutaneous talc after axillary dissection in a porcine model safely reduces drain duration and prevents seromas. J Am Coll Surg 214(3):338–347
Berkoff DJ, Kanaan M, Kamath G (2013) Fibrin glue as a non-invasive outpatient treatment for post-arthroscopic knee seromas. Knee Surg Sports Traumatol Arthrosc 21(8):1922–1924
Moritz RK, Reich-Schupke S, Altmeyer P, Stucker M (2013) Polidocanol foam sclerotherapy of persisting postoperative seromas after varicose vein surgery: a series of six cases. Phlebology 28(7):341–346
Rossetto LA, Garcia EB, Abla LE, Ferreira LM (2014) Seroma and quilting suture at the donor site of the TRAM flap in breast reconstruction: a prospective randomized double-blind clinical trial. Ann Plast Surg 72(4):391–397
Read RC, Yoder G (1989) Recent trends in the management of incisional herniation. Arch Surg 124(4):485–488
Smereczynski A, Starzynska T, Kolaczyk K, Kladny J (2014) Role of sonography in assessing complications after laparoscopic cholecystectomy. J Ultrason 14(57):152–162
Hall AB, Northern D (2012) Effect of abdominal binders on pulmonary mechanics with implications for the military surgical population. J Surg Educ 69(1):34–36
Valenca-Filipe R, Martins A, Silva A, Vasconez LO, Amarante J, Costa-Ferreira A (2015) Dissection technique for abdominoplasty: a prospective study on scalpel versus diathermocoagulation (coagulation mode). Plast Reconstr Surg Glob Open 3(1):e299
Marsh DJ, Fox A, Grobbelaar AO, Chana JS (2015) Abdominoplasty and seroma: a prospective randomised study comparing scalpel and handheld electrocautery dissection. J Plast Reconstr Aesthet Surg 68(2):192–196
Le Louarn C (1996) Partial subfascial abdominoplasty. Aesthet Plast Surg 20(2):123–127
Pollock H, Pollock T (2000) Progressive tension sutures: a technique to reduce local complications in abdominoplasty. Plast Reconstr Surg 105(7):2583–2586 (discussion 7–8)
Pollock TA, Pollock H (2012) Progressive tension sutures in abdominoplasty: a review of 597 consecutive cases. Aesthet Surg J 32(6):729–742
Antonetti JW, Antonetti AR (2010) Reducing seroma in outpatient abdominoplasty: analysis of 516 consecutive cases. Aesthet Surg J 30(3):418–425
Nahas FX, Ferreira LM, Ghelfond C (2007) Does quilting suture prevent seroma in abdominoplasty? Plast Reconstr Surg 119(3):1060–1064 (discussion 5–6)
Baroudi R, Ferreira CA (1996) Contouring the hip and the abdomen. Clin Plast Surg 23(4):551–572 (discussion 72–73)
Baroudi R, Ferreira CA (1998) Seroma: how to avoid it and how to treat it. Aesthet Surg J 18(6):439–441
Khan S, Teotia SS, Mullis WF, Jacobs WE, Beasley ME, Smith KL et al (2006) Do progressive tension sutures really decrease complications in abdominoplasty? Ann Plast Surg 56(1):14–20 (discussion—1)
Andrades P, Prado A, Danilla S, Guerra C, Benitez S, Sepulveda S et al (2007) Progressive tension sutures in the prevention of post abdominoplasty seroma: a prospective, randomized, double-blind clinical trial. Plast Reconstr Surg 120(4):935–946 (discussion 47–51)
Toman N, Buschmann A, Muehlberger T (2007) Fibrin glue and seroma formation following abdominoplasty. Chirurg 78(6):531–535
Chevrel JP (1979) The treatment of large midline incisional hernias by “overcoat” plasty and prothesis (author’s transl). Nouv Presse Med 8(9):695–696
Lee JC, Teitelbaum J, Shajan JK, Naram A, Chao J (2012) The effect of fibrin sealant on the prevention of seroma formation after postbariatric abdominoplasty. Can J Plast Surg 20(3):178–180
Kohler G, Koch OO, Antoniou SA, Lechner M, Mayer F, Emmanuel K (2014) Prevention of subcutaneous seroma formation in open ventral hernia repair using a new low-thrombin fibrin sealant. World J Surg 38(11):2797–2803
Bailey SH, Oni G, Guevara R, Wong C, Saint-Cyr M (2012) Latissimus dorsi donor-site morbidity: the combination of quilting and fibrin sealant reduce length of drain placement and seroma rate. Ann Plast Surg 68(6):555–558
Bercial ME, Sabino Neto M, Calil JA, Rossetto LA, Ferreira LM (2012) Suction drains, quilting sutures, and fibrin sealant in the prevention of seroma formation in abdominoplasty: which is the best strategy? Aesthet Plast Surg 36(2):370–373
Azoury SC, Rodriguez-Unda N, Soares KC, Hicks CW, Baltodano PA, Poruk KE et al (2015) The effect of TISSEEL fibrin sealant on seroma formation following complex abdominal wall hernia repair: a single institutional review and derived cost analysis. Hernia 19(6):935–942
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The authors of this manuscript certify that they have NO affiliations with or involvement in any organization or entity with any financial interest or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
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This study was approved by the ethical committee of Faculty of Medicine, University of Alexandria.
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The study including human participants has been performed in accordance with the ethical standards of the Declaration of Helsinki and its later amendments.
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Informed written consent was signed and obtained from all individual patients before being enrolled in the study.
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Alhussini, M.A., Awad, A.T. & Kholosy, H.M. Using quilting sutures in decreasing seroma formation after managing large ventral hernias: a comparative study. Hernia 23, 717–722 (2019). https://doi.org/10.1007/s10029-018-1850-9
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DOI: https://doi.org/10.1007/s10029-018-1850-9