Early wound-related complications and influential factors after Lichtenstein inguinal hernia repair: Lessons learned

Early wound-related complications and influential factors after Lichtenstein inguinal hernia repair: Lessons learned

Aim: The main purpose of this study was to research short-term wound-related results and complications of tension-free herniarepair, especially in the postoperative period during the length of stay in the hospital (LOS).Materials and Methods: This study had a retrospective design. Study data was collected via the 29 Mayıs State Hospital registrysystem. Between May 30, 2016, and May 30, 2019, a total of 1128 cases were screened. Patients were identified who were operatedfor tension-free inguinal hernioplasty. In total, 652 patients were included in this study. Patients with inconsistent diagnostic data,no documentation of seatbelt use, or missing outcomes were excluded. For descriptive statistical analyses, the mean and standarddeviation were used for continuous variables, and percentage and frequency values were used for dichotomous variables. Thestatistical tests were chosen according to the Kolmogorov Smirnov test. After univariate analysis, the final statistical results weredone with multiple binary logistic regressions. A 5% level was chosen as significant for p-values. Data were analysed with SPSS™for Windows 18 (SPSS, Chicago, IL). Patient demographics, hernia side, hospital LOS, body mass index (BMI) and postoperativecomplications were abstracted for each patient.Results: The total number of patients is 652 [males: 619 (94.9%) vs. females: 33 (5.1%)]. The mean age of both males and femaleswas 56.83 ± 14.3 years and 57.33 ± 11.4 years (p = .84), respectively. For both males and females, the mean BMI was 24.09 ± 6.54kg/m2 (24.12 ± 6.51 kg/m2 vs. 23.32 ± 7.07 kg/m2).The mean duration of LOS was detected as 2.45 ± 1.02 days. In the LOS period,prominently, BMI (30 kg/m2) and incarcerated-strangulated hernias were found highly significant for seroma, in statistical analysiswith multiple binary logistic regression analysis [AOR: 4.3 (1.3, 13.8) (p ≤ .05)] and [AOR: 12.1 (4.9, 29.5) (p ≤ .05)], respectively.Conclusion: For patients who have a BMI above 30 kg/m2 and especially for strangulated or incarcerated hernias, the seromacomplication may be a candidate.

___

  • 1. Shulman AG, Amid PK, Montllor MM. The tension-free hernioplasty. Am J Surg 1989;157:188–93.
  • 2. Bilsel Y, Abci I. The search for ideal hernia repair; mesh materials and types. Int J Surg 2012;10:317–21.
  • 3. Heikkinen T, Wollert S, Osterberg J, et al. Early results of a randomised trial comparing Prolene and VyproII-mesh in endoscopic extraperitoneal inguinal hernia repair (TEP) of recurrent unilateral hernias. Hernia 2006;10:34–40.
  • 4. Robinson TN, Clarke JH, Schoen J, et al. Major mesh-related complications following hernia repair: events reported to the Food and Drug Administration. Surg Endosc 2005;19:1556– 60.
  • 5. Köckerling F, Bittner R, Jacob DA, et al. TEP versus TAPP: comparison of the perioperative outcome in 17,587 patients with a primary unilateral inguinal hernia. Surg Endosc 2015;29:3750–60.
  • 6. Protasov AV, Krivtsov GA, Mikhaleva LM, et al. Effects of inguinal hernioplasty mesh implant on reproductive function. Khirurgiia (Mosk) 2010;8:28–32.
  • 7. Lichtenstein IL, Shulman AG, Amid PK. The cause, prevention and of recurrent groin hernia. Surg Clin North Am 1993;73:529–43.
  • 8. Amid PK, Shulman AG, Lichtenstein IL. Critical scrutiny of the open “tension-free “hernioplasy. Am J Surg 1993;165:369– 71.
  • 9. Friis E, Lindahl F. The tension- free hernioplasti in a randomized trial. Am J Surg 1996;172:315–9.
  • 10. Friedman DW, Boyd CA. İnguinal hernia etiology: alterarations in fibrillar collagen synthesis. Ann Surg 1993;218:754–60.
  • 11. Vychnevskaia K, Mucci-Hennekinne S, Casa C, et al. Intraperitoneal mesh repair of small ventral abdominal wall hernias with a Ventralex hernia patch. Dig Surg 2010;27:433–35.
  • 12. Hadi HI, Maw A, Sarmah S,et al. Intraperitoneal tension-free repair of small midline ventral abdominal wall hernias with a Ventralex hernia patch: initial experience in 51 patients. Hernia 2006;10:409–13.
  • 13. Rangaswamy, M. Minimizing complications in abdominoplasty: An approach based on the root cause analysis and focused preventive steps. Ind J Plast Surg 2013;46:365–76.
  • 14. Wagih Ghnnam, Ashraf Elrahawy, Magdy EL Moghazy. The effect of body mass index on outcome of abdominoplasty operations. www.wjps.ir /Vol.5/No.3/September 2016
  • 15. Emile et al. Outcomes following repair of incarcerated and strangulated ventral hernias with or without synthetic mesh. World J Emerg Surg 2017;12:31.
  • 16. Sartelli M, Coccolini F, Ramshorst G, et al. WSES guidelines for emergency repair of complicated abdominal wall hernias. World J Emerg Surg. 2013;8:50.
  • 17. Sodergren MH, Swift İ. Seroma formation and method of meSh fixation in laparoscopic ventral hernia repair– highlights of a case series. Scandinavian J Surg 2010;99:24– 7.
  • 18. Thompson JE, Taylor JB, Nazarian N, et al. Massive inguinal scrotal bladder herniase: A review of the literature with 2 new cases. J Urol 1986;136:1299–301.
  • 19. Rider MA, Baker DM. Return to work after inguinal hernia repair. Br J Surg 1993;80:745–6.
  • 20. Kark AE, Kurzer M, Waters KJ. Tension -free mesh hernia repair: Review of 1098 cases using local anaesthesia in a day unit. Ann R Coll Surg Engl 1995;77:299–304.
  • 21. Kama NA, İzbul T. Fıtık ameliyatları ile ilgili komlikasyonlar ve nüks.ağdaş Cerrahi Dergisi 1991;5:35–41.
  • 22. Moloney GE. Result of nylon-darn repairs of herniae. Lancet 1985;273–8.
  • 23. Gilbert AI, Felton LL. Infection in repair considering biomaterials and antibiotics. Surg Gynecol Obstet 1993;177:126–30.
  • 24. Szell K. Local anaesthesia and inguinal hernia repair. Ann R Coll Surg 1994;76:137–40.
  • 25. Rutkow IM, Robbins AW. “Tension-free” inguinal herniorrhaphy: A preliminary report on the “mesh plug” tecnique. Surgery 1993;114:3–8.
  • 26. Lichtenstein IL, Shulman AG, Amid PK, et al. The tensionfree hernioplasty. Am J Surg, 1989;157:188–92.
  • 27. Shulman AG, Amid PK, Lichtenstein IL. The safety of mesh repair for primary inguinal hernias. Am Surgeon 1992;58:255–7.
  • 28. Young DV. Comparison of local and general anesthesia for inguinal herniorrhaphy. Am J Surg 1987;153:560–5.
Annals of Medical Research-Cover
  • Yayın Aralığı: 12
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Evaluation of transfusion transmitted infections and distribution of ABO and Rh blood groups in donors in Eastern Turkey

Cengiz DEMİR, Ömer EKİNCİ, Sinan DEMİRCİOGLU, Mustafa MERTER, Ali Fuat GURBUZ, Ali DOGAN, Osman KARA

The effect of feeding with own mother’s milk on bronchopulmonary dysplasia in very low birth weight infants

Ismail Kursad GOKCE, Mehmet Fatih DEVECİ

Poor myocardial blush grade accompanies to higher sudden death risk scores of hypertrophic cardiomyopathy

Fatih YALÇIN, Fatma DUMAN, Mehmet KAPLAN, Oğuz AKKUŞ

The evaluation of dose distribution of vertebral growth plates in pediatric patients who underwent craniospinal radiotherapy

Hüseyin BORA, Serap ÇATLI DİNÇ, Ertugrul SENTURK, Volkan DEMİRCAN, Aybala UCGUL

Surgical technique and short-term outcomes in esophageal squamous cell carcinoma : A single center experience

Servet KARAGÜL, Oktay KARAKOSE, Kazim Çaglar OZCELİK

A new parameter in the diagnosis of acute appendicitis: Ileocolic artery and vein diameter measurements

Taha Yusuf KUZAN, Beyza NUR KUZAN, Rabia ERGELEN

The effects of acrylamide and vitamin E administration during pregnancy on adults’ ovarian tissue: An experimental study

Mehmet Erman ERDEMLİ, Zeliha SELAMOGLU, Yusuf TÜRKOZ, Zeynep ERDEMLİ, Harika GÖZÜKARA BAG

Corneal sensation and ocular surface parameters in patients with unilateral herpetic epithelial keratitis

Burak MERGEN, Cezmi DOĞAN

The evaluation of nose functions in chronic obstructive pulmonary disease

Ozge CAGLAR, Pınar MUTLU, Arzu MİRİCİ, Sibel OYMAK, Sefa DEREKÖY

Are visual and auditory reaction times influenced by Ramadan fasting? Neuro performance study on healthy individuals

Mahmut ACAK, Deniz SENOL, Elisa ÇALIŞGAN, Serkan DÜZ, Aysegul KISAOĞLU, Mustafa CANBOLAT, Davut OZBAG