Seroma Reduction and Role of Tranexamic Acid in Ventral Hernia Repair

Abstract

Objective

To evaluate the role of tranexamic acid in seroma reduction in ventral  hernia repair.

Study design

Cross sectional study.

Place & Duration of study

Department of Surgery, Ward 21, Jinnah Postgraduate Medical Center (JPMC) Karachi, from July 2019 to February 2020.

Methodology

All patients with ventral abdominal hernia were included in the study. Patients suffering from liver cirrhosis, strangulated hernias, uncontrolled diabetes and bleeding disorders were excluded. Patients on anticoagulants were advised to stop the medications five days prior to surgery. A detailed history, clinical examination and routine biochemical investigations were done. Ultrasound of abdomen and pelvis was done to find out the actual size of the defect and status of abdominal viscera. Anesthesia consult was obtained. Study was approved by institution review board and informed consent was obtained from the patients. Standard onlay mesh repair surgery was performed according to the size of defect. Tranexamic acid was given postoperatively in all patients. Drains were placed to record the volume of seroma after surgery.

Results

Total of eighty patients were included in this study. Twenty (25%) patients were male and sixty (75%) females. Age of the patients was from 20 years to 60 years. Average age was 45 year. In sixty-five (81%) patients seroma subsided within 5 days, where as in fifteen (19%) patients it took more than five days to stop. There was no statistically significant effect of age and gender on the seroma formation with P=0.179 and P= 0.627 respectively.

Conclusion

Tranexamic acid is effective in reducing the seroma formation in postoperative period in ventral hernia repairs.

Key words 

Tranexamic acid, Fibrinolysis, Plasminogen, Seroma.