Persistent Inguinal Seroma Managed With Sprinkling of Talcum Powder

A Case Report

Javier Lopez-Monclus; Miguel A Garcia-Ureña; Luis A Blázquez; Daniel A Melero; Carmen Jiménez-Ceinos

Disclosures

J Med Case Reports. 2012;6(391) 

In This Article

Abstract and Introduction

Abstract

Introduction: We present a new method to treat recurrent seromas, which is based on our experience with a patient who had recurrent groin seroma and was treated successfully with a sprinkling of talcum powder in the seroma cavity.

Case presentation: A 67-year-old Caucasian man with a suprapubic recurrent right groin hernia underwent inguinal hernioplasty with a polypropylene plug. Three days later the patient presented with a right groin fluctuating mass beneath the surgical wound with no signs of infection, and was discharged after seroma aspiration. After 23 days of increasing drainage, the seroma cavity was thoroughly dried with clean gauze swabs, and four g of sterilized dry talcum powder was sprinkled into the seroma cavity with a five-cc syringe. A compressive dressing was placed, and the patient was discharged. One week after the sprinkling of talcum powder, the surgical wound was almost closed with only minimal oozing from the drainage incision. The patient did not report any adverse effects. Two weeks later, the wound was fully healed.

Conclusion: Talcum powder sprinkling could be an effective, quick, and safe method for the treatment of inguinal seromas after inguinal hernioplasty when conservative management has failed. Nevertheless, larger series are needed before assessing this technique as the treatment of choice.

Introduction

Hernioplasty with prosthetic mesh is currently the treatment of choice for groin hernia, with lower recurrence rates than classical herniorrhaphies. Nevertheless, the use of prosthetic meshes is associated with postoperative complications such as increased rates of seroma and hematoma formation, chronic inflammation, infection, chronic pain and mesh migration.[1]

A seroma is defined as a clinically identifiable collection of serous fluid in any tissue, potential space, or cavity after an operation. Seroma etiology remains unknown, but it seems to be due to a local inflammatory response to a mechanical injury incurred by tissue aggression during surgery and the presence of foreign bodies.[2] The use of drainages does not decrease the frequency of seroma formation,[3] and a direct relationship exists between the amount of mesh in contact with subcutaneous tissue and the incidence of seroma.[4] Percutaneous or surgical drainage is required when a seroma becomes symptomatic, and this procedure is associated with a risk of infection. When a seroma persists despite successive drainages, it becomes a difficult-to-solve problem and an important impairment to the patient's quality of life.

We present a case of recurrent groin seroma after an inguinal hernioplasty that was treated successfully with a sprinkling of talcum powder in the seroma cavity.

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