Welcome to the AHS 2020 ePoster Session. Please scroll down to view all of the submitted posters or press Control-F to search. To view the poster and its abstract, click on the poster image. Many posters also have a brief audio introduction which can be played by going to the bottom of the poster screen.
P053: PREVENTING POSTOPERATIVE SEROMA FORMATION IN ABDOMINAL WALL HERNIA BY INTRAOPERATIVE HYPERTONIC SALINE IRRIGATION
Moshe M Dudai, MD, FACS1; Karen F Ittah Golan, MD2; 1Ramat Aviv Medical Center; 2Merav Medical Center
Aims: Seroma formation (SF) is a frequent post-operative complication as in Abdominal Wall Hernias (AWH) and reconstructive surgeries, where extensive dissection take place. It increases overall morbidity and can be challenging to manage. Drains, aspirations and sclerotherapy are established for treating Postoperative seromas and increase the risk for infections. No study has yet to describe the use of Intraoperative Preventive measures for SF. The purpose of this report is to describe a novel method of Intraoperative Hypertonic Saline Irrigation (IHSI) to abdominal wall subcutaneous surgical cavity, which prevent SF and enables a shorter drainage usage due to early drain removal.
Methods: This study includes 36 patients who undergone the Extended Endoscopic Hernia & Linea Alba Reconstruction Glue surgery-RFR (eEHLARglueRFR), for AWH and Rectus Muscles Separation (RMS). An extensive Endoscopic dissection of the anterior Rectus fascia is performed prior to dissecting and reducing into the abdominal cavity any hernia followed by closing of the RMS. A mesh is placed over the repaired RMS and is fused into the muscles by Fibrin Glue. The novel preventive method is based on Intraoperative Irrigation of the subcutaneous cavity through two 7mm closed system drains with 20 cc of NaCl 12% which are left in place for 20 minutes.
Results: Our results with our 36 patients over 28 months of follow up, show seroma prevention in all but one mail, lower drain secretion rate of 20cc in 10 hours and drains removal within 20 hours.
Conclusions: IHSI enhances fusion adhesions and reduce secretion rate and therefore enables early drain removal and prevent SF. As a result, reducing overall morbidity and hospitalization period, decreasing inconveniency and cost saving of multiple outpatient visits or additional surgery. This novel technique could be used in addition to AWH in many others potential postoperative SF surgeries. Further research is advised.
Key words: Hypertonic Saline, Seroma formation, Abdominal Wall hernia, Rectus Muscles Separation, Endoscopy, subcutaneous space
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