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Umbilical hernia repair in children: is pressure dressing necessary
1Department of Pediatric Surgery, Faculty of Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan. mereij@just.edu.jo
Insights
Pressure dressing after pediatric umbilical hernia repair is often routine but may be unnecessary. This study found no significant difference in outcomes like infection or recurrence between dressed and undressed wounds.
Area of Science:
- Pediatric Surgery
- Wound Management
Background:
- Pressure dressings are standard after pediatric umbilical hernia repair for hematoma prevention.
- Current practice involves leaving dressings for 5-7 days.
Purpose of the Study:
- To compare surgical outcomes of umbilical hernia repair in children using pressure dressings versus leaving wounds exposed.
- To evaluate the necessity of pressure dressings in this procedure.
Main Methods:
- Prospective randomized study of 96 children undergoing umbilical hernia repair.
- Patients were randomized into two groups: pressure dressing (n=52) or no dressing (n=44).
- Exclusion criteria included huge umbilical hernias and those requiring umbilicoplasty.
Main Results:
- One patient (1.9%) in the pressure dressing group developed wound infection; none in the exposed group did.
- No significant differences were observed in wound infection, hematoma, seroma, or recurrence rates between the groups.
- The study focused on standard umbilical hernia repairs, excluding complex cases.
Conclusions:
- Pressure dressing after umbilical hernia repair in children may not be necessary.
- Leaving surgical wounds exposed without dressing appears to yield comparable outcomes.
- This finding challenges the routine use of pressure dressings in pediatric umbilical hernia repair.
Abstract:
The use of pressure dressing to cover the sutured surgical wound is usually considered a routine conclusion to the repair of umbilical hernias in children. The wound is usually left dressed for a minimum of 5-7 days. The main purpose of pressure dressing is prevention of a hematoma formation. The aim of this study was to compare the surgical outcome after umbilical hernia repair in children when the wounds were covered using pressure dressing or left exposed without dressing after the completion of wound closure. Ninety-six patients with umbilical hernia repair were prospectively randomized to receive pressure dressing (n=52) or have their wounds left exposed without any dressing (n=44) after the completion of wound closure. None of the hernias were huge umbilical hernia and none required an umbilicoplasty. In the group who received pressure dressing, one patient developed wound infection 1.9% while no patients developed wound infection in the group who had their wounds exposed without any dressing. In children, there was no significant difference in terms of wound infection, hematoma or seroma formation and recurrence rate after applying pressure dressing or leaving the surgical wounds exposed without any dressing after completion of wound closure. Pressure dressing after umbilical hernia repair may be unnecessary.
