DOI: http://dx.doi.org/10.18203/2349-2902.isj20210925

A comparative study of mesh fixation with polypropylene sutures (prolene) versus polyglactin sutures (vicryl) sutures in assessing inguinodynia in open inguinal hernia repair

Ramesh S. Koujalagi, Vinod Karagi, Abhijit S. Gogate, Nikhil M.

Abstract


Background: Inguinal hernia, the most frequently occurring type of hernia globally, Chronic groin pain could be related to nerve mangling while operating. Mesh repair can lead to an inflammatory reaction over a period of time, though it still needs ground work to find out exact cause of pain. So this study aims to compare the effectiveness of polyglactin versus prolene sutures in reducing the post-operative pain in inguinal hernia repair.

Methods: A one year hospital prospective study in KLE hospital. A total of 60 adult patients were divided into two groups of 30 each. Mesh fixation with polyglactin sutures was group A (30) and mesh fixation with polypropylene sutures was group B (30) and then post-operative pain, was assessed. Follow-up was for 3 months. Collected data was analyzed using chi–square tests, Mann-Whitney U tests.

Results: Our analysis showed that the incidence of postoperative groin pain with mean severity scores of 1.37±0.49 versus 1.43±0.50; 1.40±0.50 versus 1.57±0.73; 1.03±0.61 versus 1.50±0.057; 0.77±0.63 versus 1.30±0.79; at post-operative day 1, 3 in both groups were similar and statistically not significant whereas the 1 week and 3 months follow up in group A and B respectively, were significant (p<0.05).

Conclusions: The post-op chronic groin pain is significantly low, hence routine usage of polyglactin sutures to fix a mesh is a safe and effective alternative to polypropylene sutures in Lichtenstein hernia repair.


Keywords


Chronic groin pain, Inguinal hernia, Lichtenstein hernia repair, Polyglactin (vicryl) sutures, polypropylene (prolene) sutures

Full Text:

PDF

References


Garba ES. The pattern of adult external abdominal hernias in Zaria. Nigerian J Surg Res. 2000;2(1):12-5.

Collins D. Bailey & Love’s Short Practice of Surgery. 25th edn. N. S. Williams, C. J. K. Bulstrode and P. R. O’Connell (eds) 283 × 225 mm. Pp. 1514. Illustrated. 2008. Hodder Arnold: London. Br J Surg. 2008;95(10):1311.

Primatesta P, Goldacre M. 1996. Inguinal Hernia Repair: Incidence of Elective and Emergency Surgery, Readmission and Mortality. Int J Epidemiol. 1996;25(4):835-9.

Schoots I, van Dijkman B, Butzelaar R, van Geldere D, Simons M. 2001. Inguinal hernia repair in the Amsterdam region 1994-1996. Hernia. 2001;5(1):37-40.

Rutkow I. Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am. 2003;83(5):1045-51.

Bay-Nielsen M, Perkins F, Kehlet H. Pain and Functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg. 2001;233(1):1-7.

Aasvang E, Kehlet H. Surgical management of chronic pain after inguinal hernia repair. Br J Surg. 2005;92(7):795-801.

Jeroukhimov I, Wiser I, Karasic E, Nesterenko V, Poluksht N, Lavy R, et al. Reduced postoperative chronic pain after tension-free inguinal hernia repair using absorbable sutures: a single-blind randomized clinical trial. J Am Coll Surg. 2014;218(1):102-7.

Perkins F, Kehlet H. Chronic pain as an outcome of surgery. Anesthesiology. 2000;93(4):1123-33.

Lilly MC, Arregui ME. Ultrasound of the inguinal floor for evaluation of hernias. Surg Endosc. 2002;16(4):659-62.

Daigeler A, Belyaev O, Pennekamp WH, Morrosch S, Köster O, Uhl W, et al. MRI findings do not correlate with outcome in athletes with chronic groin pain. J Sports Sci Med. 2007;6(1):71-6.

Mui WL, Ng CS, Fung TM, Cheung FK, Wong CM, Ma TH, et al. Prophylactic ilioinguinal neurectomy in open inguinal hernia repair: a double-blind randomized controlled trial. Ann Surg. 2006;244(1):27-33.

Kumar DPM, Sukriya DM. Role of ilioinguinal neurectomy in entrapment syndrome in inguinal hernia repair in tertiary care hospital. Indian J Appl Res. 2019;9(3).

Lau WY. History of treatment of groin hernia. World J Surg. 2002;26(6):748-59.

Negro P, Gossetti F, Ceci F, D'Amore L. Made in Italy for hernia: the Italian history of groin hernia repair. Ann Ital Chir. 2016;87:118-28.

Kharadi A, Shah V. Comparative study of mesh fixation with non-absorbable v/s delayed absorbable suture in open inguinal hernia. Int Surg J. 2016;3(3):1180-3.

Paajanen H, Kössi 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(9):1245-51.