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NOVEL TREATMENT OF REFRACTORY SEROMA AFTER INCISIONAL HERNIA REPAIR
  1. G Martel,
  2. J Ahmad,
  3. M Taylor
  1. Department of General surgery, Mater Infirmorum, Belfast, Northern Ireland

Abstract

Introduction Seroma formation is a common complication after repair of abdominal wall hernia, which can lead to significant morbidity. Despite new technologies the treatment of seroma remains a challenge. We present a case where a novel technique of percutaneous injection of a fibrin sealant was used, with subsequent full resolution.

Aims/Background A 43 year old lady with a past history of previous laparoscopic incisional hernia repair presented with a recurrence. Following open repair, she developed an extremely symptomatic seroma which was refractory to traditional treatment with multiple drainages. Subsequently a drain was inserted, and the cavity allowed to empty until collapsed. A fibrin sealant was then injected into the cavity, and the drain removed.

Method A full literature search was carried out, and any reported use of fibrin sealant in the setting of seroma formation documented. The patient was followed up a clinic one month following treatment, and clinically assessed.

Results Clinical assessment at one month follow up revealed no evidence of seroma recurrence. After full literature research there were no previously reported cases where fibrin sealant had been used to treat refractive seroma following incisional hernia repair.

Conclusion This case report presents the successful use of fibrin sealant to treat a resistant seroma after incisional hernia repair. This approach may prove to be effective in promoting resolution of troublesome seromas. Further studies are required to establish its efficacy.

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