EFFICACY OF ADRENALINE SPRAY IN REDUCING SEROMA FORMATION FOLLOWING HERNIOPLASTY: A RANDOMIZED CLINICAL TRIAL
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Keywords
Seroma formation, Hernioplasty, Adrenaline spray, Vasoconstrictive agents, Post-operative complications, Surgical wound management, Randomized controlled trial
Abstract
Objective: To evaluate the efficacy of adrenaline spray in reducing seroma formation in hernioplasty cases.
Methods: This randomized controlled trial evaluated the efficacy of adrenaline spray in reducing seroma formation. Conducted over six months at Ayub Teaching Hospital, 152 participants undergoing elective hernioplasty were randomized into two groups. The intervention group received intraoperative adrenaline spray, while the control group underwent standard care. Primary outcomes included seroma incidence, assessed clinically and via ultrasound, while secondary outcomes were post-operative complications and hospital stay duration.
Results: The incidence of seroma formation was significantly lower in the intervention group (7.9%) compared to the control group (21.1%) (P = 0.021). Although seroma severity approached significance (P = 0.057), the intervention group showed milder cases. No significant differences were observed between the groups for post-operative complications (P = 0.241) or hospital stay duration (P = 0.876). Both groups were demographically and clinically comparable, ensuring robust results.
Conclusion: Adrenaline spray effectively reduces seroma formation without increasing post-operative complications or prolonging hospital stays. This cost-effective intervention has the potential to improve hernioplasty outcomes and could be explored in other surgical contexts prone to seroma formation. Further studies with larger sample sizes and longer follow-ups are recommended
References
2. Matsumoto R, Nagahisa Y, Hashida K, Yokota M, Okabe M, Kawamoto K. Strangulated hernia can be a risk factor of seroma following laparoscopic transabdominal preperitoneal repair. Minimally invasive surgery. 2018;2018(1):6528075.
3. Ng TP, Loo BY, Chia CL. Seroma-prevention strategies in minimally invasive inguinal hernia repair: a systematic review and meta-analysis. International Journal of Abdominal Wall and Hernia Surgery. 2023 Jan 1;6(1):14-22.
4. Bullocks J, Basu CB, Hsu P, Singer R. Prevention of hematomas and seromas. InSeminars in Plastic Surgery 2006 Nov (Vol. 20, No. 04, pp. 233-240). Copyright© 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA..
5. Papanikolaou A, Minger E, Pais MA, Constantinescu M, Olariu R, Grobbelaar A, Lese I. Management of postoperative seroma: recommendations based on a 12-year retrospective study. Journal of clinical medicine. 2022 Aug 28;11(17):5062. doi: 10.3390/jcm11175062.
6. Capitán MO, Sukia IN, Crespo ER, Garcia IA, Ponce IA, Rodriguez LC, García AL, Otaegui LG. Postoperative Seroma after Hernioplasty: What can we do? A Systematic Mini-Review of Treatment Options.
7. Shrestha A, Eddama MM, Cunin L, Balakumar C, Basu S. Prospective Cohort Study to Assess the Risk of Seroma Following Giant Midline Incisional Hernia Repair with and Without Subcutaneous Medical Talc Application. Clin Surg. 2022; 7.;3600.
8. Kazzam ME, Ng P. Postoperative Seroma Management. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK585101/
9. Lipman J, Roux A, Kraus P. Vasoconstrictor effects of adrenaline in human septic shock. Anaesthesia and intensive care. 1991 Feb;19(1):61-5.
10. Shrestha A, Eddama MM, Cunin L, Balakumar C, Basu S. Prospective Cohort Study to Assess the Risk of Seroma Following Giant Midline Incisional Hernia Repair with and Without Subcutaneous Medical Talc Application. Clin Surg. 2022; 7.;3600.
11. Albala DM, Lawson JH. Recent clinical and investigational applications of fibrin sealant in selected surgical specialties. J Am Coll Surg. 2006;202(4):685-97. doi:10.1016/j.jamcollsurg.2005.11.027.
12. Di Benedetto F, Tarantino G. Topical hemostatic agents. In: Jabbour N, editor. Transfusion-Free Medicine and Surgery. 2nd ed. Wiley; 2014. p. 143-66.
13. Clark RAF. Fibrin sealant in wound repair: a systematic survey of the literature. Exp Opin Invest Drugs. 2000;9(10):2371-92. doi:10.1517/13543784.9.10.2371.
14. Edwards SJ, Crawford F, van Velthoven MH, et al. The use of fibrin sealant during non-emergency surgery: a systematic review of evidence of benefits and harms. Health Technol Assess. 2016;20(94):1-200. doi:10.3310/hta20940.
15. Eriksen JR, Bisgaard T, Assaadzadeh S, Jorgensen LN, Rosenberg J. Randomized clinical trial of fibrin sealant versus titanium tacks for mesh fixation in laparoscopic umbilical hernia repair. Br J Surg. 2011;98(11):1537-45. doi:10.1002/bjs.7646.
16. Olutoye OO, Eriksson E, Menchaca AD, et al. Management of acute wounds—expert panel consensus statement. Adv Wound Care. 2024;13(11):553-83. doi:10.1089/wound.2023.0059.
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Syed Aamer Hussain
MBBS, FCPS, CHPE, Senior Registrar of General Surgery, Ayub Teaching Hospital Abbottabad Pakistan
Rehan Ahmed Khan
MBBS, FCPS, FRCS, MHPE, PhD (Medical Education), Professor of Surgery, Islamic International Medical College, RIPHAH University Islamabad, Pakistan
Muhammad Asad
MBBS, FCPS, CHPE, Assistant Professor of General Surgery, Islamic International Medical College, RIPHAH University Islamabad, Pakistan