A comparative study between absorbable (vicryl) and non absorbable(proline) sutures for mesh fixation in lichtenstein’s hernia repair ( for postoperative complications and recurrence)

Introduction: Inguinal hernia is a protrusion of abdominal cavity with two third have indirect and one third have direct hernia. Lichtenstein’s tension free mesh hernia repair is the most widely used technique.
Aim & Objective: Find the importance of suture material used to fix the mesh in Lichtenstein’s Mesh repair with the aim of assessing and comparing the post operative outcomes on post op day 7 , 3months and 6months. Also to assess recurrence of hernia within 6 months.
Methodology: The present study is an interventional , comparative , observational study conducted among admitted patients in the department of General surgery at National Institute Of Medical Sciences & Research ,Jaipur over the time period of One And Half Year ( January 2018 to 2019 ) with the sample size of 140 patients divided in two groups each of 70 patients. In group 1 (ASM) mesh fixation done with absorbable suture material (Vicryl ) while in group 2 (NASM) non absorbable suture material (prolene) was used. Included all male patients aged 18 years to 75 years with direct inguinal hernia . The patients with associated comorbidities, emergency repair and complicated hernia were excluded.
Results &Discussion: The age group of 18 to 30 years had higher incidence of direct inguinal hernia comprising of 65 % of the total patients. In group 1(ASM) on postoperative day 7, pain was seen in 4 patients, seroma formation in 1 while wound infection in 2 and foreign body sensation in 5 patients were seen. On postoperative duration at 3 months and 6 months pain was the most common complaint seen in 5 and 4 patients respectively. In group2 (NASM ) on postoperative day 7, pain was seen in 12 patients, seroma formation in 2 while wound infection in 3 and foreign body sensation in 7 patients were seen. On postoperative duration at 3 months and 6 months pain was the most common complaint seen in 13 and 16 patients respectively. Also 12 patients have foreign body sensation while 10 patients had wound infection and 9 had seroma formation on postoperative 3 months. Even 6 months postoperatively 8 patients felt uneasiness secondary to foreign body sensation. The recurrence was seen in 1 patient in each group at 6 months postoperatively.
Conclusion: Mesh fixation using absorbable sutures in Lichtenstein’s hernioplasty is associated with lesser postoperative complications.