A Prospective Randomized Study Comparing Fibrin Glue Versus Prolene Suture for Mesh Fixation in Lichtenstein Inguinal Hernia Repair

Abstract

The aim of this study is to assess the advantages of fibrin glue over Prolene suture in fixation of the mesh in open inguinal hernia repair. Sixty-four cases of inguinal hernia underwent hernia repair by the Lichtenstein method in the department of surgery in PGIMER & Dr. RML Hospital, New Delhi. The patients were randomized prospectively into group A (fibrin glue group) and group B (Prolene suture group). In group A, fibrin glue was used for mesh fixation, and in group B, Prolene suture was used for mesh fixation. The mean age of patients in group A was 44.5 years and that of group B patients was 44.2 years. There was a significant difference in the duration of surgery, with the mean duration in fibrin glue group being 30.6 min and that of the suture group was 43.3 min. The mean visual analogue pain score of postoperative pain at 1, 6, 12, and 24 h was significantly higher in the suture group than in the fibrin glue group (p<0.001). The mean total dose of analgesia in ampoules of tramadol was significantly less in the fibrin glue group (1.56 ampoules) than that in the suture group (4.125 ampoules) with p=0.000. At the end of the first month, 25 % of subjects in the suture group presented with mild groin pain (p value=0.0048). At the end of the second and third month, 22 % (p 68 value=0.0048) and 12.5 % (p value=0.1132) of subjects respectively presented with mild groin pain in the suture group. The present study demonstrates that the use of fibrin glue in place of Prolene suture for mesh fixation in open inguinal hernia repair can help decreasing the time required for surgery, reduce the intensity of postoperative pain, shorten the duration of hospital stay, and prevent the incidence of chronic groin pain.

Acceptance of Fibrin Glue Fixation in Lichtenstein Hernia Repair: a Faraway Dream

“…Sir, we have read the article comparing fibrin glue with polypropylene suture for mesh fixation in patients undergoing open inguinal hernia repair by Karigoudar et al with interest [1]. Short operative time, less post intervention pain, reduction in postoperative hospitalization period, and prevention of chronic groin pain were the benefits attributed to fibrin glue fixation in this study.…”

Meta‐analysis of postoperative pain using non‐sutured or sutured single‐layer open mesh repair for inguinal hernia

“…Of 2682 articles identified by the literature search, 51 were selected for full‐text assessment and 29 articles met the inclusion criteria. After removing duplicate articles, 25 were included in the meta‐analysis, representing 23 studies ( Fig . ).…”

“…One study had a multiarm trial design comparing cyanoacrylate glue fixation and ProGrip™ self‐gripping mesh with suture fixation of the mesh. Five studies reported on fibrin glue fixation, eight on cyanoacrylate glue fixation and 11 on the use of ProGrip™ self‐gripping mesh. Of the 23 articles included in the meta‐analysis, 15 provided the incidence of chronic pain at 12 months, according to the definition provided in the methods.…”

“…One study was excluded as it did not report on complications. Fifteen studies reported on haematoma formation, 12 on seroma formation and 11 on surgical‐site infection.…”

“…Summary of risk of bias across included studies 260-273 had a multiarm trial design comparing cyanoacrylate glue fixation and ProGrip™ self-gripping mesh with suture fixation of the mesh. Five16,25,30,32,36 studies reported on fibrin glue fixation, eight29,33,37,39,42,43,45,46 on cyanoacrylate glue fixation and 11…”