Seroma in ventral incisional herniorrhaphy: incidence, predictors and outcome.
BACKGROUND
Factors 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.
Kaafarani
Haytham M A
HM
VA Boston Healthcare System, West Roxbury, MA, USA.
Hur
Kwan
K
Hirter
Angie
A
Kim
Lawrence T
LT
Thomas
Anthony
A
Berger
David H
DH
Reda
Domenic
D
Itani
Kamal M F
KM
D000368:Aged; D015897:Comorbidity; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology*; D049291:Seroma / Q000453:epidemiology*; D013514:Surgical Procedures, Operative / Q000379:methods