From the Guidelines
Complications after hernia repair surgery in pediatric patients can include infection, recurrence, bleeding, damage to surrounding structures, testicular complications, and reactions to anesthesia, with the risk of complications being generally low due to the congenital nature of pediatric hernias and the robust immune systems of children 1.
Potential Complications
- Infection at the incision site, which may present with redness, swelling, or drainage
- Recurrence of the hernia, occurring in approximately 1-3% of cases
- Bleeding or hematoma formation
- Damage to surrounding structures such as blood vessels or nerves
- Testicular complications in boys, including swelling or atrophy
- Reactions to anesthesia
Management of Complications
Pain is common but typically manageable with acetaminophen (10-15 mg/kg every 4-6 hours) or ibuprofen (5-10 mg/kg every 6-8 hours) for 2-3 days post-surgery. Parents should monitor for fever above 101.5°F, increasing pain despite medication, persistent vomiting, inability to urinate within 8-12 hours after surgery, or significant swelling or bruising, as these may indicate complications requiring immediate medical attention.
Evidence-Based Recommendations
The use of ketorolac, a nonopioid medication, has been shown to be effective in reducing postoperative pain and opioid requirements in children undergoing inguinal hernia repair 1. Additionally, the use of biological mesh in contaminated fields has been found to be safe and effective in reducing the risk of complications, although the long-term durability of biological mesh has not been fully established 1.
Quality of Life
Most children recover fully within 1-2 weeks with minimal complications, and the risk of complications is generally low due to the congenital nature of pediatric hernias and the robust immune systems of children. However, it is essential to monitor for potential complications and seek medical attention immediately if any concerns arise.
From the Research
Potential Complications after Hernia Repair Surgery in Pediatric Patients
- The potential complications after hernia repair surgery in pediatric patients include:
- Wound seroma/hematoma 2
- Urinary retention 2
- Superficial incisional infection 2
- Seroma formation 2
- Wound infection 2, 3
- Mesh infection 2, 4
- Scrotal edema 3
- Haematoma 3
- Recurrence of hernia 3, 5
- Testicular atrophy 5
- Hydrocele 5
- Vas injury 5
- Late abscess formation following indirect hernia repair utilizing silk suture 6