A COMPARATIVE STUDY OF INGUINAL HERNIA USING MONOFILAMENT NON-ABSORBABLE SUTURE VERSUS MONOFILAMENT DELAYED ABSORBABLE SUTURE FOR MESH FIXATION IN LICHTENSTEIN TENSION FREE HERNIA: REPAIR RANDOMIZED CONTROLLED STUDY (SINGLE BLINDED)
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Abstract
Introduction: A hernia occurs when tissue or an organ, like the bowel, protrudes through the normal cavity wall. Various techniques for mesh implantation involving sutures are used to secure the mesh in place and prevent migration, wrinkling, and curling. Aim: To enhance the quality of life for patients and decrease complications of inguinal hernia repair, specifically chronic groin pain, without impacting the recurrence rate.
Methodology: Seventy patients admitted to our institute with proven diagnosis of inguinal hernia and admitted from 1st August 2022 to 31st January 2024 were included in the study, and were subjected to delayed absorbable or non- absorbable monofilament suture for mesh fixation in lichtenstein tension free hernioplasty, with follow up. Chronic groin pain in post op assessed by VAS score, seroma formation, and wound infection was compared in both groups.
Results: Among the participants subjected to Prolene suture, 7/35 (20%), 8/35 (22.9%) and 1/35 (2.9%) showed wound infection on day 4, 5, and 15, respectively. Among the participants subjected to PDS material, 5/35 (14.3%), 6/35 (17.1%) and 1/35 (2.9%) showed wound infection on days 4,8 and 15, respectively. The p value was found to be > 0.05.
Among the participants subjected to Prolene, 7/35 (20%) showed seroma formation on day 8, as compared to this complication noted in only 1 case (2.9%) among PDS group. Prolene group accounts to major occurrence of scrotal edema as compared to PDS group. The two cases who underwent repair using Prolene material showed recurrence on post-operative days 30 and 90 (1/35;2.9% each).
Conclusion: This study concludes that the use of absorbable suture such as PDS has superior benefit over non-absorbable suture Prolene, in preventing the post-operative complications after Lichtenstein Tension-Free Hernia repair.
References
2. Igor j, Wiser I, Karasic E, Nesterenko V, Poluksht N, Lavy R, et al. Reduced pain after tension free inguinal repair using absorbable sutures: a single blind randomised clinical trial. J Am Coll Surg. 2014;218:102-7.
3. Matikainen M, Vironen J, Kossi J, Hulmi T, Hertsi M, Rantanen T, Paajanen H. Impact of mesh and fixation on chronic inguinal pain in lichtenstein hernia repair: 5-Year outcomes from the finn mesh study. World J Surg2021;45:459–64.
4. Meena LN, Bansal S, Verma P, Rai R. A comparative study of postoperative chronic pain after tension free inguinal hernia repair using absorbable versus non absorbable sutures for mesh fixation. Int Surg J 2018;5(4):1378-81.
5. Mui WL, Ng CS, Fung TM, Chenug FK, Wong CM, Ma TH. Prophylactic ilioinguinal neurectomy in open inguinal hernia repair: a double blinded randomised controlled trial. Ann Surg. 2006:244:27-33.
6. Bay-Nielsen M, Nilsson E, Nordin P et al (2004) Chronic pain after open mesh and sutured repair of indirect hernia in young males. Br J Surg 91:1372–76.
7. Kharadi A, Shah V. Comparative study of mesh fixation with non-absorbable v/s delayed absorbale suture in open inguinal hernia. Int Surg J. 2016;3(3);1180-3.
8. Redha AGM, Jaber AA, Nasser AM. The difference in outcome of patients with open inguinal hernia repair by using delayed absorbable sutures instead of non-absorbable sutures for mesh fixation. Int Surg J 2021;8:24-7.
9. Patchayappan M, Narayanasamy SN, Duraisamy N. Three stitch hernioplasty: A novel technique for beginners. Avicenna J Med. 2015;5:106-9.
10. Aasvang E, Kehlet H. Surgical management of chronic pain after inguinal hernia repair. Br J Surg. 2005;92:795-801.
11. Paajanen H, Kossi J, Silvasti S, Hulmi T, Hakala T. Randomized clinical trial of tissue glue versus absorbable sutures for mesh fixation in local anaesthetic Lichtenstein hernia repair. Br J Surg. 2011;98:1245-51.
12. Lionetti R, Neola B, Dilillo S, Bruzzese D, Ferulano GP. Sutureless hernioplasty with light-weight mesh and fibrin glue versus Lichtenstein procedure: a comparison of outcomes focusing on chronic postoperative pain. Hernia. 2012;16:127-31.
13. Kim-Fuchs C, Angst E, Vorburger S, Helbling C, Candinas D, Schlumpf R. Prospective randomized trial comparing sutured with sutureless mesh fixation for Lichtenstein hernia repair: long-term results. Hernia. 2012;16:21-7.
14. Pierides G, Scheinin T, Remes V, Hermunen K, Vironen J. Randomized comparison of self-fixating and sutured mesh in open inguinal hernia repair. Br J Surg. 2012;99:630-6.
15. Rahul BG, Ravindranath GG. Incidence of inguinal hernia and its type in a study in a semiurban area in Andhra Pradesh, India. Int Surg J 2016;3:1946-9.
16. Charles, M. R., Christian, L. B., Sen, T., Mahapatra, S., & Joshi, B. R. (2013). A Two year Retrospective Study of Congenital Inguinal Hernia at Western Regional Hospital. Journal of Nepal Medical Association, 39(133), 172–175. https://doi.org/10.31729/jnma.687
17. Saeed AB, Rabee B, Aram FO, Abdulla A. Inguinal hernia repair by Darning. Yemeni.j.Med.Sci 2009;3(1):1-5
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Dr Bhuvaneshwari Gachinmath
Postgraduate, S. Nijalingappa Medical College and HSK Research Centre, Bagalkote, Karnataka
Dr Mahantesh Math
MBBS MS Mch, Assistant Professor in General Surgery, S. Nijalingappa Medical College and HSK Research Centre, Bagalkote, Karnataka
Dr Bailappa A Kolhar
Professor and Head of the Unit General Surgery, S. Nijalingappa Medical College and HSK Research Center, Bagalkote, Karnataka
Dr B V Goudar
Professor and Head of unit General Surgery Department, S. Nijalingappa Medical College and HSK Research Center, Bagalkote, Karnataka
Dr Rajendra Benkatti
MBBS MS, Professor in General Surgery, S. Nijalingappa Medical College and HSK Research Centre, Bagalkote, Karnataka