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Hernia

, Volume 17, Issue 4, pp 459–463 | Cite as

Medical talc increases the incidence of seroma formation following onlay repair of major abdominal wall hernias

  • R. Parameswaran
  • S. T. Hornby
  • A. N. Kingsnorth
Original Article

Abstract

Purpose

Seroma is a well established complication of the repair of major abdominal wall hernias, occasionally requiring aspiration and reoperation. Medical talc seromadesis (MTS) has been described in the literature. The aim of this study was to determine the effect of MTS on seroma formation after onlay repair of incisional hernia.

Methods

A retrospective review of a prospective database was conducted for 5 months from April 2011, when 21 consecutive patients received MTS. Outcomes were compared with a published and validated series from the same unit.

Results

There were no differences in basic demographics and co-morbidities between the two groups. The mean BMI was 34 for the MTS group. The incidence of recurrent incisional hernia prior to surgery was greater in MTS (9/21 vs. 36/116, p = 0.39). The mean area of fascial defect measured intra-operatively and mesh used to cover the incisional hernia defect was 170 and 309 cm2 for the MTS group. The mean operating time was 152 min and a mean of 10 g of medical talc was used for seromadesis. The seroma rate increased from 11/116 (9.5 %) to 16/21 (76 %) (p = 0.001) as did the rate of superficial wound infection 10/116 (8.6 %) to 9/21 (43 %) (p = 0.03) in the MTS group. There was no difference in the length of in-hospital stay between the two groups.

Conclusions

The application of medical talc increased the rate of seroma formation and superficial wound infection in patients undergoing open ‘onlay’ repair of major abdominal wall hernia.

Keywords

Ventral hernia Onlay repair Talc Seromadesis Seroma 

Notes

Conflict of interest

RP, STH, and ANK declare no conflict of interest.

References

  1. 1.
    Korenkov M, Paul A, Sauerland S, Neugebauer E, Arndt M, Chevrel JP et al (2001) Classification and surgical treatment of incisional hernia. Results of an experts’ meeting. Langenbecks Arch Surg 386(1):65–73PubMedCrossRefGoogle Scholar
  2. 2.
    Chevrel JP, Rath AM (2000) Polyester mesh for incisional hernia repair. In: Schumpelick V, Kingsnorth A (eds) Incisional hernia. Springer, New York, pp 327–333Google Scholar
  3. 3.
    Kingsnorth AN, Shahid MK, Valliattu AJ, Hadden RA, Porter CS (2008) Open onlay mesh repair for major abdominal wall hernias with selective use of components separation and fibrin sealant. World J Surg 32(1):26–30PubMedCrossRefGoogle Scholar
  4. 4.
    Itani KM, Rosen M, Vargo D, Awad SS, Denoto G III, Butler CE (2012) Prospective study of single-stage repair of contaminated hernias using a biologic porcine tissue matrix: the RICH Study. Surgery 152:498–505PubMedCrossRefGoogle Scholar
  5. 5.
    Downey SE, Morales C, Kelso RL, Anthone G (2005) Review of technique for combined closed incisional hernia repair and panniculectomy status post-open bariatric surgery. Surg Obes Relat Dis 1(5):458–461PubMedCrossRefGoogle Scholar
  6. 6.
    Amid PK, Shulman AG, Lichtenstein IL, Hakakha M (1994) Biomaterials for abdominal wall hernia surgery and principles of their applications. Langenbecks Arch Chir 379(3):168–171PubMedCrossRefGoogle Scholar
  7. 7.
    Mortenson MM, Xing Y, Weaver S, Lee JE, Gershenwald JE, Lucci A et al (2008) Fibrin sealant does not decrease seroma output or time to drain removal following inguino-femoral lymph node dissection in melanoma patients: a randomized controlled trial (NCT00506311). World J Surg Oncol 6:63PubMedCrossRefGoogle Scholar
  8. 8.
    Kaafarani HM, Hur K, Hirter A, Kim LT, Thomas A, Berger DH et al (2009) Seroma in ventral incisional herniorrhaphy: incidence, predictors and outcome. Am J Surg 198(5):639–644PubMedCrossRefGoogle Scholar
  9. 9.
    Shaw P, Agarwal R (2004) Pleurodesis for malignant pleural effusions. Cochrane Database Syst Rev (1):CD002916Google Scholar
  10. 10.
    Klima DA, Brintzenhoff RA, Tsirline VB, Belyansky I, Lincourt AE, Getz S et al (2011) Application of subcutaneous talc in hernia repair and wide subcutaneous dissection dramatically reduces seroma formation and postoperative wound complications. Am Surg 77(7):888–894PubMedGoogle Scholar
  11. 11.
    Lehr SC, Schuricht AL (2001) A minimally invasive approach for treating postoperative seromas after incisional hernia repair. JSLS 5(3):267–271PubMedGoogle Scholar
  12. 12.
    Holthouse DJ, Chleboun JO (2001) Talc serodesis–report of four cases. J R Coll Surg Edinb 46(4):244–245PubMedGoogle Scholar
  13. 13.
    Belyansky I, Tsirline VB, Klima DA, Walters AL, Lincourt AE, Heniford TB (2011) Prospective, comparative study of postoperative quality of life in TEP, TAPP, and modified Lichtenstein repairs. Ann Surg 254(5):709–714PubMedCrossRefGoogle Scholar
  14. 14.
    Sandblom G, Gruber G, Kald A, Nilsson E (2000) Audit and recurrence rates after hernia surgery. Eur J Surg 166(2):154–158PubMedCrossRefGoogle Scholar
  15. 15.
    Nordin P, Haapaniemi S, Kald A, Nilsson E (2003) Influence of suture material and surgical technique on risk of reoperation after non-mesh open hernia repair. Br J Surg 90(8):1004–1008PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  • R. Parameswaran
    • 1
    • 2
  • S. T. Hornby
    • 2
  • A. N. Kingsnorth
    • 2
  1. 1.Department of Upper GI SurgeryThe Maidstone and Tunbridge Wells HospitalMaidstoneUK
  2. 2.Derriford Hospital, Plymouth Hospitals NHS Trust, and Peninsula College of Medicine & DentistryPlymouthUK

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