Effective Position of Closed Suction Drain in Inguinal Hernia Surgery: A Retrospective Study.

ABSTRACT

Background: The aim of this study was to assess the efficacy of closed suction drains in inguinal hernia surgery inserted up to the base of the scrotum as compared to those in which the drain is limited to the inguinal region. Methods: Data of all lichtenstein hernioplasty from January 2012 to December 2014 in M. S. Ramaiah Medical Hospital were collected retrospectively. A total of 992 patients underwent hernia repair and only 133 patients were subjected to closed suction drain. In 133 patients data were collected regarding the type of presentation, age, gender, presence of coexisting diseases, type of hernia, type of anesthesia, postoperative general complications, data was collected regarding the presentation of the hernia, type of sac encountered, amount of dissection, location of the inserted drain, complications, and length of hospital stay. These patients were followed up for 6 months. Local wound complications, duration of operation, and length of hospitalization, recurrence and mortality were compared between the groups of patients with drains versus without drains. Results: Average amount of drain fluid was higher (58.5 ml) in the group where the drain was inserted to the bottom of the scrotum as compared to (22.4 ml) the group with the drain limited to the inguinal region. Furthermore, there was significant difference in the incidence of scrotal edema in the two groups (6 vs. 23). Hence, by positioning the drain to reach the bottom of the scrotum; it will lead to a better drainage of the collection and in turn lead to fewer associated complications such as scrotal hematomas, infections, and scrotal edema. Conclusion: In our study, placement of drain extending into the bottom of scrotum significantly reduced scrotal edemas a result alleviates immediate post-operative patient anxiety and morbidity in the reduction of scrotal size to normal. However, it requires a larger series to confirm our early observations.