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  • 1
    ISSN: 1433-0385
    Keywords: Key words: Inguinal hernia ; Drainage ; Complications ; Ultrasound. ; Schlüsselwörter: Leistenhernie ; Drainage ; Komplikationen ; Sonographie.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. In einer prospektiven randomisierten Studie wurden im Rahmen der Shouldice-Reparation primärer Hernien 50 Patienten mit subcutaner Redon-Drainage und 50 Patienten ohne Drainage versorgt. Postoperativ erfaßten wir die Menge des produzierten Wundsekrets in der Drainageflasche sowie durch sonographische Volumetrie, das Maß der subjektiven Beeinträchtigung mittels visueller Analogskala, die Höhe der Entzündungsparameter sowie die Komplikationsrate. Am ersten postoperativen Tag fand sich im drainierten Kollektiv mit 36,0 ml eine signifikant erhöhte Flüssigkeitsproduktion im Vergleich zu 2,5 ml in der Gruppe ohne Drainage. Zwei Wundinfekte wurden ebenfalls im drainierten Kollektiv beobachtet. Percutane Serompunktionen waren bei 8 Patienten, die ohne Drainage operiert wurden, und bei 7 drainierten Patienten notwendig. Das subjektive Empfinden war durch die Drainage nur geringfügig (25,6 vs. 21,4 %, visuelle Analogskala) beeinträchtigt. Die Körpertemperatur war im Drainagekollektiv am 3. postoperativen Tag im Vergleich zur nicht drainierten Gruppe erhöht (37,2 vs. 36,7 °C). Das routinemäßige Einlegen einer Redon-Drainage bei der Reparation primärer Leistenhernien ist aus unserer Sicht nicht indiziert. Vielmehr sollte bei Auftreten einer subcutanen Flüssigkeitsansammlung großzügig die Indikation zur percutanen Punktion gestellt werden.
    Notes: Summary. Following Shouldice repair of a primary inguinal hernia 50 patients were given subcutaneous Redon drains, while another 50 patients underwent operations without drains in a prospective randomized trial. The amount of postoperative wound secretion in the drainage bottle was added to fluid retention established by sonographic volumetric analysis. The degree of personal impairment was estimated by a visual analogue score. Inflammation parameters were recorded as well as the rate of complications. The drain group showed significantly increased fluid production in comparison to the group without drains on the 1st postoperative day (36.0 vs. 2.5 ml). Wound sepsis was found in two patients in the drain group. Seven patients with drains and eight patients without underwent percutaneous seroma puncture. The drain only slightly affected personal impairment (25.6 % vs 21.4 %, visual analogue score). Body temperature was elevated in the drain group on the 3rd day after operation (37.2 vs 36.7 °C). We believe there is no indication for the routine use of a Redon drain in the repair of a primary inguinal hernia. Instead, percutaneous puncture of subcutaneous fluid retentions should be performed.
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  • 2
    ISSN: 1432-2218
    Keywords: Key words: Hernia — Inguinal hernia repair — Liquid retention — Ultrasound — Volumetry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Daily routine has shown that there are differences between the aspirated volumes of subcutaneous liquid retention after inguinal hernia repair and the results of sonographic-based volumetry using the standard rotating ellipsoid formula. Methods: In 83 patients, subcutaneous fluid retention after Shouldice repair was visualized by ultrasound and calculated as cuboid, cylinder, and rotating ellipsoid, respectively. The results were compared to the aspirated volume. Data were analyzed retrospectively. Results: The volume obtained by percutaneous punction averaged 12.18 ± 1.50 ml. The calculated volumes were distinctly less: cuboid, 11.98 ± 1.59 ml; cylinder, 10.26 ± 1.45 ml; rotating ellipsoid, 5.99 ± 0.80 ml. We found different coefficients of regression for the aspirated and the calculated volumes (cuboid; 0.75; cylinder; 0.82; rotating ellipsoid; 1.50). The coefficients of correlation, however, were 0.79 for all modes of calculation. Conclusion: Because its results were closest to the aspirated volumes, we recommend the cuboid formula for the ultrasound-based calculation of liquid retention after inguinal hernia repair.
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