Comparing sutures and human fibrin glue for mesh fixation during open inguinal hernioplasty

The aim of this study is to evaluate pain and further disabling complications in patients undergoing Lichtenstein technique for primary inguinal hernia repair by fixing the mesh with fibrin sealant versus sutures.

This study was carried out on 116 patients between January 2009 and July 2009. All patients were male, between the ages of 20 and 75 years. Lichtenstein, using a polypropylene mesh as prosthetic material. A total of 116 hernias were operated on. Group I: 54 operations were done using the conventional repair procedure with polypropylene sutures (prolene 2/0) for mesh fixation. Group II: 62 operations were done using fibrin glue for fixation of the mesh. All patients were operated as day cases, with a maximum hospital stay of 12 hours; none required readmission.

No complications were observed in follow-up at 1 week, 1 month, 6 months and 12 months. At 12 months, none of the patients had developed a recurrence. The mean time for complete healing of wound after herniorrhaphy plus fibrin sealant was 8.13±7.88 days (range 6-28 days). This was markedly increased in group 1 patients (mean 12.08±8.59days, and range 8-32) (p <0.001).12 months after surgery, The median VAS pain score was significantly lower in group 2 patients (P < 0·001). The mean (SD) duration of incapacity for work was 5 (2-12) days in group 2(p <0.001).

This study confirms the effectiveness of fibrin glue in securing prosthetic meshes and reducing chronic inguinal pain.

Chronic pain, Fibrin glue, Inguinal hernia repair.