Introduction: Seroma and wound breakdown are commonest post-operative complication after open ventral 
hernia repair with massive skin and subcutaneous reconstruction. Following open ventral hernia, these occur 
in 12-20% and increase to 17-34% when combined with massive skin and subcutaneous reconstruction. This 
study evaluates a novel technique of applying talc powder to subcutaneous flaps to prevent seroma 
formation.
Patients and Methods: Sixty one patients of ventral hernia with skin and subcutaneous reconstruction were 
admitted to surgery department in Zagazig University Hospital. They were randomly divided into two 
groups .The PRE group did not receive talc therapy, and the POST group received talc therapy in the 
subcutaneous dissection. A prospectively collected surgical outcomes database was accessed identifying all 
patients. Demographics, peri-operative data, and outcomes were analyzed.
Results: PRE group consisted of 31 patients and POST group consisted of 30 patients. Complication rates for 
PRE/ POST goups were: cellulitis or oral antibiotics 35.5%-13.3%, intravenous antibiotics 9.7%-3.3%, 
operative/radiologic intervention for wound infection 19.4%-13.3%, seroma intervention 19.4%-3.3%, wound 
breakdown12.9%- 3.3% and hernia recurrence 9.7 %- 0%. Of these, seroma intervention and hernia recurrence 
were significantly decreased in the POST group (p0.013, p0.032). Mean drain duration was 27.4 days for PRE 
and 16.3 days for POST (p0.004). Mean follow-up was 5.6 months for PRE and 2.5 months for POST (p0.032).
Conclusion: The addition of talc powder made a dramatic difference in patient outcomes. We found a 
decreased percentage of wound complications, with a significant reduction in seroma formation, recurrence, 
and drain duration. The use of talc powder is simple and easy for high risk patients to avoid post-operative 
complications especially seroma and wound break.