Influence of injection site for low-dose heparin on wound complication rates after inguinal hernia repair.

A high incidence of complications related to bleeding was observed after open prosthetic inguinal hernia repair. The site of injection of low-dose heparin into the abdominal wall was thought to be a possible causal factor for these complications. The wound complication rate after repair of primary unilateral inguinal hernias was recorded for 51 patients who had been given abdominal wall injections of heparin. Subsequently the injection site was changed to the upper limb in a further 63 patients and the incidence of wound complications recorded. A significantly higher incidence of haematomas and seromas was found in the abdominal wall injection group (39.2% vs 17.5%, P = 0.01). The role of low-dose heparin prophylaxis in inguinal hernia repair is discussed. We conclude that in those patients receiving heparin prophylaxis the injections should be given at a site remote from the operative area.