Year: 2026 | Month: September | Volume: 16 | Issue: 9 | Pages: 285-292
DOI: https://doi.org/10.52403/ijhsr.20260930
A Prospective Comparative Study Between Quilting Technique and Conventional Closure in Preventing Seroma Formation After Ventral Hernia Repair
Manoj Kumar M1, Rajeshwari M2, Kalpanadevi A K3, Mohammed Thaha S4, Sahasyaa Adalarasan5
1Junior Resident, Institute of General Surgery, Madras Medical College, Chennai, India;
2Assistant Professor, Institute of General Surgery, Madras Medical College, Chennai, India;
3Professor, Institute of General Surgery, Madras Medical College, Chennai, India;
4Medical Student, Institute of General Surgery, Madras Medical College, Chennai, India.
Corresponding Author: Sahasyaa Adalarasan
ABSTRACT
Introduction: Seroma formation is one of the most common complications following ventral hernia repair and is associated with patient discomfort, delayed wound healing, prolonged drain placement, and increased risk of wound infection. Quilting sutures have been proposed as a simple technique to obliterate dead space and reduce postoperative fluid accumulation. This study aimed to compare the quilting technique and conventional closure in patients undergoing ventral hernia repair.
Methods: This prospective comparative study was conducted in the Department of General Surgery, Rajiv Gandhi Government General Hospital, Chennai, over a period of 12 months. A total of 60 patients undergoing elective ventral hernia repair were included and equally allocated into two groups: quilting closure (n=30) and conventional closure (n=30). All patients underwent on-lay mesh repair with closed suction drain placement. Postoperative drain output, duration of drain placement, hospital stay, and postoperative complications were assessed. Statistical analysis was performed using SPSS version 26.0. Continuous variables were compared using the independent samples t-test, while categorical variables were analysed using the Chi-square test or Fisher’s exact test. A p-value <0.05 was considered statistically significant.
Results: Baseline demographic and clinical characteristics were comparable between the two groups. Postoperative drain output, used as an indirect indicator of postoperative fluid accumulation, was significantly lower in the quilting group on postoperative day 1 (41.0 ± 12.4 ml vs 51.7 ± 6.5 ml, p=0.0001), postoperative day 2 (21.7 ± 8.5 ml vs 34.0 ± 8.4 ml, p<0.0001), postoperative day 3 (13.0 ± 8.5 ml vs 25.8 ± 7.0 ml, p<0.0001), and in total drain output (75.7 ± 23.5 ml vs 111.5 ± 19.4 ml, p<0.0001). The quilting group also demonstrated earlier drain removal (3.7 ± 0.8 days vs 4.8 ± 0.7 days, p<0.0001), shorter hospital stays (4.0 ± 1.0 days vs 6.6 ± 1.1 days, p<0.0001), lower surgical site infection rates (23.3% vs 73.3%, p=0.0001), and no cases of late infection compared with 60.0% in the conventional closure group (p<0.0001). These findings suggest reduced postoperative fluid accumulation and potentially lower seroma formation in patients undergoing quilting closure.
Conclusion: Quilting closure following ventral hernia repair was associated with lower postoperative drain output, earlier drain removal, shorter hospital stays, and reduced postoperative wound complications compared with conventional closure. The findings suggest that quilting sutures are an effective and simple technique for reducing postoperative fluid accumulation and improving recovery following ventral hernia repair.
Key words: ventral hernia repair, quilting technique, seroma formation, on-lay mesh repair, drain output, surgical site infection, postoperative complications, conventional closure.