Pathophysiology of Seroma Formation and Its Preventive Measures in Cases of Ventral Hernia

Background: Seroma is an abnormal collection of serous fluid in the dead space of the wound. The origin of this serous fluid remains unclear. Seroma formation can be seen as a consequence of the inflammatory foreign body reaction with monocytes and macrophages involved at the interface of connective tissue and implant. These cells produce a variety of cytokines, which regulate the local immune response, wound healing and scar formation. Seroma causes discomfort to the patient, prolonged hospital stay, and infection at the operation site and reoperations. Seroma is of one the most common complications following open techniques and is particularity likely to occur when large skin flaps are developed during the surgical procedure so closure of the dead space may reduce the risk of seroma formation. Though the risk for seroma formation increases when mesh is used for repair, little is known about the genesis of seroma formation. Alloplastic mesh prosthesis led to a multitude of tissue reactions, including the postoperative release of cytokines.