ROLE OF WOUND DRAINS VS ABDOMINAL BINDER AND PERCUTANEOUS ASPIRATION AFTER OPEN REPAIR OF VENTRAL HERNIA USING POLYPROLENE MESH

Background: Abdominal wall hernias are among the most common of all surgical problems. Ventral hernia repair (VHR) is a commonly performed operation so hernia defect size affects operative time and surgical technique for repair of a ventral hernia. Incisional hernia is the most frequent postoperative complication following general surgery. Complications of ventral hernia repair include seroma, hematoma, wound infection, bowel injury, bowel obstruction, recurrence whether earlyorlate,the mostcommoncomplicationisseroma formation.New advances in the management of ventral hernias including different methodsofrepaireitheropenor laparoscopic and differentmesh types: non-absorbable partially absorbable and absorbable. Objectives: This study was done to review and assess thedifference between insertion of wound drain and the use of abdominal binder and percutaneousaspirationafteropenrepairofventralherniasanditseffect on postoperative outcome. Patients and Methods: A total of 100 patients with non-complicated abdominal wall (ventral) hernia were enrolled to review andassess the difference between insertion of wound drain and the use of abdominal binder and percutaneous aspiration after open repair of ventral hernias and its effect on postoperative outcome. Patients were divided into two groups: Group (A) includes 50 patients with insertion of wound drain. Group (B) includes 50 patients with application of abdominal binder immediately postoperatively for 2 weeks. Results: This study showed distribution of patients according to age, ranging from 27 years to 70 years with mean age of 49.2 years (±11.6 years).25% of patients below 39, 50 % of patients below 50 and 75% ofpatientsbelow59.75.Inourstudy,60%ofoperationswerecarriedout under spinal anesthesia and 40% of operations were carried out under general anesthesia. Out of 100 patients of our study, in 28 % of cases, the hernial content was intestine and in 72 of cases the hernial content wasomentum.Outof100patientsofourstudy,therewasdevelopingof significant seroma in (30%) of patients as follow: (17%) at group A (with drain)& (13%) at group B (without drain). Significant seroma was not seen in (70%) of patients. Wound infection was developed in (18%)ofpatientsasfollow(12%)forgroupA(withdrain)and(6%)for groupB(withoutdrain).Woundinfectionnotseenin(82%)ofpatients. Out of 100 patients of our study, (2%)oftotalcountonlyshowing earlyrecurrencethatpresentat group B. (9%) of total count only complained of persistent postoperativepainasfollows, 6 cases fromgroup (A) and 3 casesfrom group (B). Mean hospital stay was 1.46 days for group (A) and 1.26 daysforgroup(B).Meanperiodbeforereturningto normalactivitywas 3.7weeksforgroup(A)and2.9weeksforgroup(B). Conclusion: Combined abdominal binder and percutaneous aspiration for selected caseswere superior to insertionof wound drains asregards seroma formation, wound infection and postoperativereturn to normal activity with no significant difference as regards hematoma, postoperative pain, hospital stay andpatientsatisfaction.