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DRAIN SITE HERNIAS - A RARE BUT RECOGNIZED COMPLICATION OF SURGICAL DRAINAGE. A STUDY OF THEIR RISK FACTORS, MANAGEMENT AND PREVENTION

PREETHA RANI KUMARPRASAD

Abstract


Herniation through drain site is a rare but
recognized complication of surgical
drainage. Once detected they should be
managed aggressively since incidence of
obstruction is higher. We herein present
two cases of drain site hernia which we
encountered in our unit between Aug
2009 to Aug 2011 . We reviewed the
case reports of these patients and analyzed
them retrospectively. The risk factors
for the development of drain site hernias
in these patients were identified.
The modalities to prevent these risk factors
and to make drain site hernia as an
avoidable complication were formulated.
We identified the main predisposing factors
for drain site hernia as sepsis, faulty
technique in placement and management
of drains. Management varied
based on their site, nature, duration of
presentation. One case presented as
emergency which we managed by open
technique, while the
second case was repaired electively using
laparoscopic technique.


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References


Teasdale C, Kenyon GS, Jones SM. External

strangulated small-bowel hernia after

intraperitoneal drainage. Lancet 1982;1

(8269):459.

Lee R, Raftery AT. Evisceration of small

bowel at the site of an intra-abdominal

drain: A complication of steroid therapy?

Br J Clin Pract 1982; 36(7–8):282–283.

Mosche Schein. To Drain or not to

Drain? The Role of Drainage in the Contaminated

and Infected Abdomen: An International

and Personal Perspective.

World J Surg (2008) 32:312–321

Wrable J, Jr, River T. Small-bowel incarceration

in a drain site hernia. N J Med

;83(3):181–182.

Kjossev KT, Losanoff JE. Complication

of prophylactic intraperitoneal drainage.

Dig Dis Sci 2001;46(11):24–56.

Gurusamy KC, Camraj K, Mullerat P,

Davidson DR. Routine abdominal drainage

for uncomplicated laparoscopic cholecystectomy.

Cochraine Database Syst

Rev 2007 ; (4): CD006004

Kumar M, Yang SB, Jaiswal VK, Shah

JN, Shrestha M, Gongal R.

Is Prophylactic placement of drains

necessary after subtotal gastrectomy?

World J Gastrenterol 2007; 13:3738-

Franchi M, Trimbos JB, Zanaboni F,

v d Velden J, Reed , Coens C,

Teodorovic I, Vergote I. Randomized

trial of drains versus no drains following

radical hysterectomy and pelvic

lymph node dissection: A European

Organization for Research and Treatment

of Cancer Group (EORTC-GCG)

study in 234 patients. Eur J Cancer.

;43:1265-8.

. Tsujinaka S, Kawamura YJ, Konishi

F, Maeda T, Mizokami K. Pelvic

drainage for anterior resection revised:

use of drains in anastomotic

leaks. ANZ J Surg. 2008; 78:461-5

Kulkarni S, Krijgsman B, Sharma

D, Kaisary AV. Incarcerated small

bowel hernia through drain site. Ann R

Coll Surg Engl 2004; 86:24-5

Komuta K, Haraguchi M, Inoue K,

Furui J, Kanematsu T. Herniation of

the small bowel through the port site

following removal of drains during

laparoscopic surgery. Dig Surg

;17:544–546.

Judy CB, James MN, Allan CW.

Richter’s Hernia in the laparoscopic

era: Four case reports and review of

the literature. Surg Laparosc Endosc

Percutan Tech 2003;13(1):55–58.

Kulkarni S, Krijgsman B, Sharma

D, Kaisary AV. Incarcerated smallbowel

hernia through drain site. Ann R

Coll Surg Eng 2004;86(6):24–25.

Chinnusamy palanivelu. Laparoscopic

Management of Drain-Site Incisional

Hernias Following Laparotomies—

A Simple Suture Technique

journal of laparoendoscopic & advanced

surgical techniques Vol 17, No.

, 2007

Jones DB, Callery MP, Soper NJ.

Strangulated incisional hernia at trocar

site. Surg Laparosc Endosc

;6:152–154.


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