Surgical Unit, Margret Marquart Catholic Hospital, Kpando, Ghana.
Department of Surgery, School of Medicine, University of Health and Allied Sciences, Ho, Ghana.
Hernia. 2022 Feb;26(1):123-130. doi: 10.1007/s10029-021-02430-8. Epub 2021 Jun 11.
Inguinal hernia is a common male surgical disease. Intervention carries a wide range of complications such as scrotal haematoma and seroma which may require surgical re-intervention or predispose patients to developing infections, pains or feeling of mass. This could lead to long hospital stay. Scrotal tamponade by bandaging or wearing of tight pants and elevation are practiced to reduce bleeding and haematoma formation. These methods require prolong use. Closed suction drains are scarcely used in resource-deprived communities due to high cost and non-availability.
This study was to determine the effectiveness of a closed non-suction drain in preventing scrotal collection requiring further surgical intervention and the predisposition to developing surgical site infection following nylon darn repair of inguinoscrotal hernia.
Forty (40) participants were recruited for a preliminary study and assigned into control and interventional groups (CG, IG) for purposes of inserting flexible feeding tube (FFT) wound drain after nylon darn (ND) repair. Daily measurement of drained scrotal collection was carried out in the IG till the day drainage was zero. Residual volumes in IG and wound collection in the CG who were not candidates for re-intervention were determined at 14th and 28th post-operative days using ultrasound scan. Data were analyzed using SPSS version 25.
Three (3) patients (15.8%) in the CG required re-intervention. Surgical site infection rates for the CG and IG were, respectively, 2/19 versus 0/21 (ρ = 0.134).There was a numerical significant difference in the mean volumes of scrotal collections between the control (0.95 ± 0.42 ml) and the intervention group (0.44 ± 0.33 ml) [p value of 0.041] but with no clinical impact.
Simple inexpensive flexible feeding tube placement significantly reduced scrotal collection which forms a base for larger sample size in subsequent studies. This could reduce the feared risk of re-intervention, wound infection and long hospital stay post-operative.
腹股沟疝是一种常见的男性外科疾病。干预措施会带来广泛的并发症，如阴囊血肿和血清肿，这可能需要再次手术干预，或者使患者更容易发生感染、疼痛或有肿块感。这可能导致住院时间延长。通过包扎或穿紧身裤和抬高阴囊来进行阴囊填塞，以减少出血和血肿形成。这些方法需要长时间使用。由于成本高和无法获得，在资源匮乏的社区很少使用封闭式负压引流。
本研究旨在确定在尼龙缝合修复腹股沟阴囊疝后，使用封闭式非负压引流管预防需要进一步手术干预的阴囊积血，并预防手术部位感染的发生。
对 40 名参与者进行了初步研究，并将他们分为对照组和干预组（CG、IG），以便在尼龙缝合修复后插入柔性喂养管（FFT）引流伤口。IG 组每天测量引流的阴囊积血量，直到引流量为零。在 14 天和 28 天的术后，使用超声扫描确定 IG 中未进行再次干预的患者的残留量和 CG 中的伤口积血量。数据使用 SPSS 版本 25 进行分析。
CG 中有 3 名（15.8%）患者需要再次干预。CG 和 IG 的手术部位感染率分别为 2/19 与 0/21（ρ=0.134）。CG 组和 IG 组阴囊积血量的平均值分别为 0.95±0.42ml 和 0.44±0.33ml（p 值为 0.041），存在显著差异，但无临床影响。
简单廉价的柔性喂养管放置显著减少了阴囊积血，为后续研究提供了更大的样本量基础。这可以降低再次手术干预、伤口感染和术后住院时间延长的风险。
