Surgical Management of Open Umbilical & Open Ventral Hernia Repairs with Novel Fish Skin Grafts for Prevention of Seroma Formation

Introduction: Seromas are reported in nearly all cases of hernia repair after radiologic imaging. Clinically symptomatic seromas are reported in up to 12.5% of patients following incisional hernia repairs. Every patient who has an open hernia will develop some element of seroma due to potential spaces of the abdominal wall. Treatment includes observations, abdominal binders, repeated aspirations, closed suction drainage and sclerotherapy. Seromas can carry risk of prolonged hospital stays, delayed healing, infection, abscess formation and skin necrosis.Fish skin graft(FSG) is a unique biologic scaffold resembling the dermal extracellular matrix. FSG is rich in Omega3 that is anti-inflammatory, promotes cellular ingrowth and neovascularization. We hypothesize that FSG can be used as part of the surgical intervention for hernia repairs as this decreases the incidence of seroma formation and the risk of potential infection.Methods:A pilot study of 8 patients with ventral/umbilical hernias treated by Michael Romberg Hernia defects varied from small to large. Cut to the abdomen and the hernia sac was reduced. Hernia closed with mesh underlayment and then the fascia was closed primarily and the FSG applied over fascia closure.Results:Complete healing was achieved in all cases without complications. Application of FSG resulted in absence of seroma formation that led to successful healing. Patients reported less pain.Discussion: FSG us ab effective alternative to conventional intervention of open hernia repairs. The use of FSG is safe, prevents seroma formation and results in rapid healing with reduced infection rates.References: