ABSTRACT

Background: Open inguinal hernia repair is still one of the most commonly performed surgery globally. Chronic post inguinal pain and recurrence are the two most reported complications of the surgery. Mesh fixation technique is believed to have a role in both these complications.

Aim: To compare the short- and long-term outcomes associated with open hernia repair and mesh fixation using suture versus skin staples in terms of recurrence, post-operative pain and wound infection rates

Methods: A randomized control trial was designed with a sample size of 30 cases in each arm conducted at three teaching hospitals from December 2017 till June 2018. All eligible candidates were evaluated and randomized into two groups at the time of Lichtenstein open hernia repair for either fixation of mesh with staples or sutures. Short and long term outcome measures were compared using t-test and chi-square tests with a p-value <0.05 was taken as statistically significant.

Results: A total of 71 patients enrolled in study with 30 finally recruited in each arm (PS vs SS groups). Patients in each group were matched for age and gender mean operative time and mesh fixation times were calculated and compared (61.47±14.44 vs 53.17±10.23) and (17.70±2.26 versus 13.97±2.55); both variables were statistically significant. There was no statistical difference in other variables including post operative pain, seroma formation and long term pain.

Conclusion: Skin Staples can be safely used in the setting of primary repair of inguinal hernias. The short- and long-term outcomes are comparable to conventional polypropylene suture and there is no significant difference in the results when the procedure is performed by trained trainees or consultants.

Keywords: Inguinal hernia, Lichtenstein repair, Mesh fixation, Skin staples, polypropylene suture