- 作者：Haytham M.A. Kaafarani ; Kwan Hur ; Angie Hirter ; Lawrence T. Kim ; Anthony Thomas ; David H. Berger ; Domenic Reda ; Kamal M.F. Itani
- 关键词：Seroma ; Ventral hernia ; Postoperative wound infection
- 刊名：The American Journal of Surgery
- 出版年：2009
- 出版时间：November 2009
- 年：2009
- 卷：198
- 期：5
- 页码：639-644
- 全文大小：276 K
BackgroundFactors leading to seroma following ventral incisional herniorrhaphy (VIH) are poorly understood.Methods
Between 2004 and 2006, patients were prospectively randomized at 4 Veterans Affairs hospitals to undergo laparoscopic or open VIH. Patients who developed seromas within 8 weeks postoperatively were compared with those who did not. Multivariate analyses were performed to identify predictors of seroma.
Results
Of 145 patients who underwent VIH, 24 (16.6 % ) developed seromas. Patients who underwent open VIH had more seromas than those who underwent laparoscopic VIH (23.3 % vs 6.8 % , P = .011). Seroma patients had hernias that were never spontaneously reducible (0 % vs 21 % , P = .015), had more abdominal incisions preoperatively (mean, 2.4 vs 1.8; P = .037), and were less likely to have drain catheters placed than those without seromas (30.0 % vs 63.1 % , P = .011). In multivariate analyses, open VIH predicted seroma (odds ratio, 5.5; 95 % confidence interval, 1.6–18.8), as well as the specific hospital at which the procedure was performed. Spontaneous resolution occurred in 71 % of seromas; 29 % required aspiration.
Conclusions
Procedural characteristics and hernia characteristics rather than patient comorbidities predicted seroma in VIH.