The Effect of Intravenous Tranexamic Acid on Reduction of Seroma After Para-Umbilical Mesh Hernioplasty

Abstract

Background

Paraumbilical hernia is the second most common presentation in adults. It is managed surgically. Surgical management depends upon the size of the defect. Sizes of more than 2cm are surgically managed by placement of mesh after primary closure of defect. Mesh can be onlay, sublay or inlay depending upon its placement at different anatomic sites of anterior abdominal wall. Seroma formation is one of the major complication of mesh hernioplasty. Different methods are used for prevention of seroma post operatively. These methods include drain placement, proper fascial closure, fibrin glue and use of sclerosing agents. Tranexamic acid can be used for prevention of seroma formation after mesh hernioplasty.

Patients and Methods

It was a case control trail conducted in department of general surgery Gulab Devi Hospital Lahore. In our study 40 patients were included through randomized sampling having paraumbilical hernia undergoing mesh hernioplasty. These patients were divided in two groups. In group 1 patient received Injection Tranexamic acid 1gm pre operatively while in group 2 inj tranexamic acid was not given.

Results

Seroma formation after drain removal was seen in 04(10%) patients only. Out of these 04 patients 01(25%) patient belonged to group 1 while 03(75%) patient were in group 2 which was proved statistically (p-value 0.004). Patients with increased BMI had seroma (26.7 ± 2.1 kg/m² vs 25.7 ± 1.8 kg/m²) but it was not statically proved (p-value 0.84). Patients with seroma had mean weight of 89 ± 10.7 kg while patients with no seroma had mean weight of 74 ± 11.5 kg which was statistically proved (p-value 0.018).

Conclusion

Injection tranexamic acid 1gm given pre operatively significantly reduces seroma formation as incidence of seroma formation was higher in group 2 as compared to group 1 patients.