Title: An Evaluation of serum IgE in Atopic patients -predictor for Post-Operative Mesh reaction
Authors: Vishnuvarthan Selvaraj, Viswanathan Gurusamy, Renganathan Dass Nagasamy, Rashmi Subramanian
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.72
Abstract
Background: In the modern surgical practice, Hernioplasty remains the commonest surgical procedure in general surgery. Though most of the patient recovers completely without complications, certain number of patients experience a stormy and complicated post-operative period in terms of seroma, infection, pain and last but not the least mesh reaction which is a rare but serious complication. Current day practice involves hernioplasty with polypropylene mesh rather than herniorraphy in most surgical centres, hence every effort should be made to reduce mesh related complications. Mesh reactions are more common in patients with preexisting allergic diseases like atopic dermatitis, asthma, allergic rhinitis, seasonal urticarial and also in patients with elevated serum IgE levels. This retrospective observational study was conducted in patients who underwent open inguinal and ventral hernioplastyfrom March 2010 to Feb 2017 in the Department of General Surgery, Coimbatore medical college hospital, Coimbatore. This study focuses mainly on patients who developed mesh reaction in the post-operative period particularly in patients who have existing atopic manifestations. After analyzing the results of our study, we conclude that IgE antibodies estimation pre-operatively in patients with existing allergic diseases can be used as a predictor for assessing mesh related reactions in the post-operative period. In this continuation we are planning immuno-electrophoresis to pinpoint the gamma globulin associated with mesh reaction.
Keywords: Hernioplasty; Mesh reactions; IgE; Atopy.
