Serum analyses for protein, albumin and IL-1-RA serve as reliable predictors for seroma formation after incisional hernia repair.
OBJECTIVE
The aim of this study was to identify potential parameters as predictors for seroma formation after incisional hernia mesh repair.


METHODS
The incidence of postoperative seroma was determined prospectively in 37 patients who underwent incisional hernia repair with lightweight polypropylene-polyglactin composite mesh (Vypro-II®). Postoperative seroma manifestation was related to patient characteristics (gender, age, BMI, comorbidity, nicotine abuse) and to preoperative serum concentration of total protein, albumin, interleukin-1-receptor-antagonist (IL-1-RA), propeptid-III-procollagen, hyaluronan and fibronectin. Ultrasound investigation was performed on postoperative days 1, 2, 3, 8 and 10.


RESULTS
Ten patients (27%) developed seroma with a mean volume of 77 ± 88 ml. Higher BMI correlated with increased seroma formation (P = 0.038). In patients with seroma, total protein (67 ± 7 vs 72 ± 4 g/l; P = 0.037), albumin (42 ± 3 vs 40 ± 4 g/l; P = 0.018) and IL-1-RA (1.4 ± 1 vs 0.8 ± 0.6 U/ml; P = 0.048) exhibited significantly altered serum concentrations in comparison to patients without seroma formation. No significant differences were seen in any other parameters.


CONCLUSIONS
High BMI, lowered preoperative serum concentration of total protein and albumin, and high serum concentration of IL-1-RA are related to an elevated risk for postoperative seroma formation.
Department of Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany. cklink@ukaachen.de
C D
CD
Klink
M
M
Binnebösel
A H
AH
Lucas
A
A
Schachtrupp
J
J
Grommes
J
J
Conze
U
U
Klinge
U
U
Neumann
K
K
Junge
D000368:Aged; D001798:Blood Proteins / Q000032:analysis*; D015992:Body Mass Index; D016009:Chi-Square Distribution; D005260:Female; D005353:Fibronectins / Q000097:blood; D059685:Herniorrhaphy; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D053590:Interleukin 1 Receptor Antagonist Protein / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D049291:Seroma / Q000175:diagnosis* / Q000209:etiology; D012709:Serum Albumin / Q000032:analysis*; D018709:Statistics, Nonparametric; D013526:Surgical Mesh
D001798:Blood Proteins; D005353:Fibronectins; D053590:Interleukin 1 Receptor Antagonist Protein; D012709:Serum Albumin; D006820:Hyaluronic Acid