Randomised Prospective Study to Compare Outcomes of Para Umbilical Hernia On-Lay Open Mesh Repair, with and without Drain

Abstract

Objective: To compare the outcomes of open on-lay mesh hernia repair with and without the use of a drain in PUH cases, with the goal of determining the most favorable post-operative outcome. Methodology: A prospective clinical study was conducted at the Department of General Surgery, Islamabad Medical Complex, NESCOM, a tertiary care hospital in Islamabad, Pakistan from January 2022 to December 2022. Fifty patients were enrolled and divided equally into two treatment groups (Groups A and B), with and without drain placement, respectively. The occurrence of complications such as seroma, hematoma formation, wound dehiscence, mesh infection, and length of hospital stay were compared between the two groups. Results: Postoperative complications were more prevalent in Group A (with drain placement) compared to Group B. Seroma formation was more common in Group A (40% on the 5th day and 16% on the 14th day post-repair) compared to Group B (16% on the 5th day and 4% on the 14th day). Hematoma formation was also higher in Group A (12% on the 5th day) compared to Group B (8% on the 5th day); however, both groups showed a 4% incidence on the 14th day. Infected mesh was more frequent in Group A (8%) compared to Group B (4%), resulting in increased morbidity. Conclusions: In small-sized para-umbilical hernia cases undergoing open on-lay mesh repair, the presence of a drain did not significantly affect the rate of postoperative complications. Seroma formation and infection incidence did not vary significantly between groups. However, patients with drain placement experienced a significantly longer hospital stay post-surgery.