Effectiveness of Drainless versus Drained Onlay Mesh Hernioplasty in Patients Undergoing Elective Open Ventral Hernia Repair: A Prospective Interventional Study

Abstract

Introduction: Ventral Hernia Repair (VHR) is one of the most frequently performed surgical procedures worldwide. The two commonly used surgical techniques for ventral hernia are onlay and sublay repairs. The use of drains in hernioplasty is controversial, as some studies suggest an increased incidence of surgical site infections. Aim: This study aims to compare the postoperative outcomes between patients who had drains placed and those who did not, undergoing elective open VHR. Materials and Methods: A prospective interventional study was conducted at the Department of General Surgery, Chettinad Hospital and Research Institute, Kelambakkam, Tamil Nadu, India. The study duration was one year, from September 2020 to September 2021. A total of 50 hernia patients participated, with 25 undergoing drainless and 25 undergoing drain onlay mesh hernioplasty. Surgical complications such as surgical site infection, seroma formation, and duration of hospital stay were observed and compared between the two groups. Independent t-tests and Chi-square tests were used to compare continuous and categorical variables, respectively. Results: Out of 50 patients, 15 (60%) in the drain group were aged between 11 to 60 years, while 11 (44%) in the drainless group were aged between 18 to 40 years. Postoperative seroma was present in 6 (12%) patients, with an equal distribution in both groups (p-value >0.05). Surgical site infection was present in 3 (60%) and 2 (40%) patients in group A and group B, respectively (p-value >0.05). The mean duration of hospital stay was 6.36±1.89 and 4.92±1.91 days in group A and group B, respectively (p-value=0.010). Conclusion: The presence or absence of a drain did not significantly affect the formation of seroma among the participants. The incidence of infection did not vary significantly with or without the use of a drain.