O28 APPLICATION OF MICROPOROUS POLYSACCHARIDE HEMOSPHERES DURING TRANSVERSUS ABDOMINAL RELEASE TO REDUCE SEROMAS AND HEMATOMAS. (25th November 2021)

• Record Type: Journal Article
• Authors: Johannes, Wegdam; de Jong, Dite; Nienhuijs, Simon; Schipper, Ellis; Berkvens, Elske; de Vries Reilingh, Tammo
• Is Part Of: British journal of surgery. Volume 108:Supplement 8(2021)
• Publication Date: 2021-11-25
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znab396.027
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Aim: Wound complications, like seromas and hematomas, occur in 23% after transversus abdominis release (TAR). Hemostat agents like fibrin glue have potential to reduce this rate, by vessel sealing and tissue bonding. But these are expensive. A topical hemostatic, like microporous polysaccharide hemospheres (MPH), is much cheaper, but its potential to reduce seromas and hematomas has never been analyzed in ventral hernia surgery. Material and Methods: After the first 25 consecutive TAR patients (Control group, 2016-2018), MPH was introduced as an adjunct in a consecutive group of 25 TAR patients (Intervention group, 2019-2020). MPH was sprinkled in the TAR planes and subcutaneous tissue. Groups were compared. Results: Pre-operative base-line characteristics and the overall complexity of the hernia patients and operations did not differ between the two groups. Postoperatively, the overall rate of surgical site occurrences (SSO) differed (CG:60%;IG:32%), but not significantly. Seromas (CG:5%;IG: 3%) and hematomas (CG:28%;IG:8%) did not differ significantly between the two groups. Medical complications (CG:13%;IG:10%) and two-year recurrence rate (CG:12%;IG:16%) also did not differ. Conclusions: This study did not demonstrate a clear effect of MPH on the incidence of SSO, seromas or hematomas after a transversus abdominis release, despite the high incidence of wound complications in the first group of TAR patients (presumably, reflecting the learning curve of TAR). The fact that MPH does not glue tissue layers and minimize dead space, may be causative. MPH is not advised as an adjunct to reduce SSO.