Abdominal Binder to Reduce Pain and Seroma Formation

Postoperative seroma formation is one of the most common complications after ventral hernia repair. Although some seromas may not have clinical impact postoperative seroma formation often causes pain and discomfort and may even compromise wound healing. Several interventional procedures have been investigated to reduce or avoid postoperative seroma formation such as removal of the hernia sac, VAC (vacuum-assisted closure) therapy, talcum application to the subcutaneous layer, suction etc., but results are conflicting and evidence is of poor quality. The use of postoperative abdominal binder is often recommended after ventral hernia repair to prevent seroma and diminish pain, but still with no scientific evidence. Randomized, controlled, multi-center, investigator-blinded study supplemented with blinded statistical analysis (see below). 56 patients (2 x 28, umbi/epi) Due to power calculations. An intention to treat analysis is done. Patients are randomized either to abdominal binder or no abdominal binder. The abdominal binder is worn from immediately after the operation and continuously for 7 days, night and day. The belts are standard elastic belts (ostomy belts) from "ETO garments©" with standard height of 22 cm. and five different sizes in width (S, M, L, XL, XXL- depending on waist measure). A fitting will be done before the operation by waist measurement according to the recommendation from the company. Patients are followed-up for 30 days with clinical follow-up at day 7 and 30.

Inclusion criteria

• Elective, primary and recurrent laparoscopic umbilical and epigastric hernia repair with mesh reinforcement
• Fascia defects 2-8 cm measured preoperatively by the surgeon at the out-patient clinic for umbi/epi
• Elective, primary and recurrent laparoscopic trocar-site hernia
• Patients between 18-80 years

Exclusion criteria

• Open ventral hernia repair
• Expected low compliance (language problems, dementia and abuse etc.)
• Fascia defects >8 cm at the preoperative clinical examination.
• Acute operation
• Chronic pain syndrome
• Decompensated liver cirrhosis (Child-Pugh B-C)
• Patients with a stoma
• If a secondary operation is performed during the hernia repair procedure