Skip to main content
SpringerLink
Log in

Retromuscular drain output at removal does not influence adverse outcome rate in open ventral hernia repairs

  • 2023 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Retromuscular drains are commonly placed during retromuscular hernia repair (RHR) to decrease postoperative wound complications and help mesh in-growth. Drains are traditionally removed when output is low but the relationship between drain output at the time of removal and postoperative complications has yet to be delineated. This study aimed to investigate outcomes of RHR patients with drain removal at either high or low output volume.

Methods

An institutional review board-approved retrospective chart review evaluated adult patients undergoing open RHR with retromuscular drain placement between 2013 and 2022 at a single academic medical center. Patients were stratified into low output drainage (LOD, < 50 mL/day) or high output drainage (HOD, ≥ 50 mL/day) groups based on volume on the day of drain removal.

Results

We identified 336 patients meeting inclusion criteria: 58% LOD (n = 195) and 42% HOD (n = 141). Demographics and risk factors pertaining to hernia complexity were similar between cohorts. Low-drain output at the time of removal was associated with a significantly longer drain duration (6.3 ± 4.5 vs. 4.4 ± 1.6 days, p < 0.001) and postoperative hospital stay (5.9 ± 3.6 vs. 4.8 ± 2.8 days, p < 0.001). With a 97% 30-day follow-up, incidence of surgical site occurrence (SSO) was not statistically different between groups (29.2% LOD, 26.2% HOD, p = 0.63). Surgical site infection and SSO requiring procedural intervention was also not statistically significant between cohort. At 1-year follow-up, hernia recurrence rates were the same between groups (4.2% LOD, 1.4% HOD, p = 0.25).

Conclusion

Following open ventral hernia repair with retromuscular mesh placement, the rate of postoperative wound complications was not statistically different based on volume of drain output day of removal. These results suggest that removing drains earlier despite higher output is safe and has no effect on short- or long-term hernia outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Novitsky YW, Elliott HL, Orenstein SB, Rosen MJ (2012) Transversus abdominis muscle release: a novel approach to posterior component separation during complex abdominal wall reconstruction. Am J Surg 204(5):709–716

    Article  PubMed  Google Scholar 

  2. Pauli EM, Rosen MJ (2013) Open ventral hernia repair with component separation. Surg Clin North Am 93(5):1111–1133

    Article  PubMed  Google Scholar 

  3. Gurusamy K, Allen VB (2013) Wound drains after incisional hernia repair. Cochrane Database System Rev (12):CD005570. https://doi.org/10.1002/14651858.CD005570.pub4

  4. Krpata DM, Prabhu AS, Carbonell AM, Haskins IN, Phillips S, Poulose BK, Rosen MJ (2017) Drain placement does not increase infectious complications after retromuscular ventral hernia repair with synthetic mesh: an AHSQC analysis. J Gastrointest Surg 21(12):2083–2089

    Article  PubMed  Google Scholar 

  5. Kushner B, Smith E, Han B, Otegbeye E, Holden S, Blatnik J (2021) Early drain removal does not increase the rate of surgical site infections following an open transversus abdominis release. Hernia 25(2):411–418

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Plymale MA, Harris JW, Davenport DL, Smith N, Levy S, Roth JS (2016) Abdominal wall reconstruction: the uncertainty of the impact of drain duration upon outcomes. Am Surg 82(3):207–211

    Article  PubMed  Google Scholar 

  7. DeBord J, Novitsky Y, Fitzgibbons R (2018) SSI, SSO, SSE, SSOPI: the elusive language of complications in hernia surgery. Hernia 22:737–738

    Article  CAS  PubMed  Google Scholar 

  8. Scevola S, Youssef A, Kroll SS (2002) Drains and seromas in TRAM flap breast reconstruction. Ann Plast Surg 48:511–514

    Article  PubMed  Google Scholar 

  9. Tabaqchali MA, Hanson JM, Proud G (1999) Drains for thyroidectomy/parathyroidectomy: fact or fiction? Ann R Coll Surg Engl 81:302–305

    CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA

    Andrea M. Meyer, Antoinette Hu, Alexander T. Liu, Diane H. Jang, Rolfy A. Perez Holguin, Colin G. Delong, Eric M. Pauli & Charlotte M. Horne

  2. Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Penn State Milton S. Hershey Medical Center, 500 University Drive, M.C. H149, Hershey, PA, 17033, USA

    Antoinette Hu, Alexander T. Liu, Rolfy A. Perez Holguin, Colin G. Delong, Eric M. Pauli & Charlotte M. Horne

Authors
  1. Andrea M. Meyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antoinette Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alexander T. Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Diane H. Jang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rolfy A. Perez Holguin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Colin G. Delong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eric M. Pauli
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Charlotte M. Horne
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Charlotte M. Horne.

Ethics declarations

Disclosures

Charlotte M. Horne is a lecturer for Medtronic and Bard Davol. Eric M. Pauli is a lecturer for Becton–Dickinson and Medtronic, he is a consultant for Boston Scientific, Actuated Medical, Cook Biotech, Neptune Medical, Surgimatix, Noah Medical, Allergan, Intuitive Surgical. Integra, and Steris, receives royalties from UpToDate (Wolters Kluwer) and Springer, and has financial interests in IHC Inc, Contamination Source Identification, and Cranial Devices Inc. Andrea M. Meyer, Antoinette Hu, Alexander T. Liu, Diane H. Jang, Rolfy A. Perez Holguin, Colin G Delong have no conflicts of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Meyer, A.M., Hu, A., Liu, A.T. et al. Retromuscular drain output at removal does not influence adverse outcome rate in open ventral hernia repairs. Surg Endosc 38, 356–362 (2024). https://doi.org/10.1007/s00464-023-10428-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-023-10428-9

Keywords

Search

Navigation