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Prevention of Subcutaneous Seroma Formation in Open Ventral Hernia Repair Using a New Low-Thrombin Fibrin Sealant

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Abstract

Background

Seroma formation is a frequent postoperative complication following open ventral hernia repair (OVHR), especially in cases requiring wide subcutaneous dissection (WSD). The aim of this study was to evaluate the effectiveness of a new low-thrombin fibrin sealant for seroma prevention.

Methods

A total of 60 consecutive patients with median incisional hernias who required OVHR with WSD of at least 100 cm2 were included in the prospective non-randomized study. The fibrin glue group (FG) comprised 30 patients who had undergone OVHR with sublay mesh placement as well as subcutaneous application of low-thrombin fibrin sealant. This cohort of patients was compared with a control group (CG) of 30 consecutive patients who had previously undergone OVHR without prevention of seroma formation with regard to outcome measures such as seroma formations and wound complications.

Results

Though the median extent of subcutaneous dead space was larger in the FG than in the CG (229 vs.174 cm2; p = 0.012), seroma formation occurred in three of the FG versus 16 of the CG patients (p = 0.003). Postoperative wound complications occurred in two of the FG versus nine of the CG patients (p = 0.002). Four patients in the CG and none in the FG required re-operation within 30 days (p < 0.001).

Conclusion

The use of a new low-thrombin fibrin glue demonstrated a protective effect against formation of seromas and decreased the rate of wound complications in OVHR, with consecutive shorter length of hospital stay (5.8 vs. 10.4 days; p = 0.04).

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Abbreviations

OVHR:

Open ventral hernia repair ( sublay or open IPOM with ventral fascial closure

WSD:

Wide subcutaneous dissection ( at least 100 cm²]

FG:

Patient cohort who received Artiss® fibrin glue application

CG:

Control group of patients

IPOM:

Intraperitoneal onlay Mesh (repair)

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Acknowledgments

The authors acknowledge the kind statistical support from Mag. Michael Stumpner.

Conflict of interest

Gernot Köhler, Oliver Owen Koch, Stavros A. Antoniou, Michael Lechner, Franz Mayer, and Klaus Emmanuel have no conflicts of interest or financial ties to disclose. All authors do disclose all institutional or corporate/commercial relationships going back 36 months and longer.

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Authors and Affiliations

  1. Department of General and Visceral Surgery, Sisters of Charity Hospital, 4010, Linz, Austria

    Gernot Köhler, Oliver Owen Koch & Klaus Emmanuel

  2. Center for Minimally Invasive Surgery, Hospital Neuwerk, Moenchengladbach, Germany

    Stavros A. Antoniou

  3. Department of Surgery, Paracelsus Medical University, Salzburg, Austria

    Michael Lechner & Franz Mayer

Authors
  1. Gernot Köhler
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  2. Oliver Owen Koch
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  3. Stavros A. Antoniou
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  4. Michael Lechner
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  5. Franz Mayer
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  6. Klaus Emmanuel
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Correspondence to Gernot Köhler.

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Köhler, G., Koch, O.O., Antoniou, S.A. et al. Prevention of Subcutaneous Seroma Formation in Open Ventral Hernia Repair Using a New Low-Thrombin Fibrin Sealant. World J Surg 38, 2797–2803 (2014). https://doi.org/10.1007/s00268-014-2691-z

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  • DOI: https://doi.org/10.1007/s00268-014-2691-z

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