E-ISSN 2146-8133
 

Original Research (Original Article) 


A comparative study of skin staples versus sutures for fixing mesh in tension-free mesh hernioplasty

Mumtaz Ud Din Wani, Azher Mushtaq, Mohammad Yaqoob Bhat, Shabir Ahmad Mir.

Abstract
Background: In open anterior inguinal mesh hernioplasty, the commonly used method for mesh fixation is by polypropylene sutures which involves extensive mesh fixation and placement of sutures into periosteum of pubic symphysis, thereby increasing the operative time with attendant risk of infection of the prosthetic material. An alternative to sutures is the use of staples which are easy to use and quick to apply. We explored the use of staples in securing the mesh in inguinal hernioplasty.
Methodology: A prospective comparative study of 400 patients who underwent inguinal mesh hernioplasty with 200 patients selected randomly each in polypropylene suture (PPSG) and staple group (SG) was performed. Postoperatively patients were made ambulatory on the same day of surgery and discharged from hospital on 1st or 2nd day in both the groups. Follow-up was carried out in 1 week, 2 months, 6 months, 1 year, 2 years, and 3 years and the patients were assessed for wound infection, hematomas, local pain, return to work, recurrence if any, and other miscellaneous complications if any.
Results: The mean age of patients in our study in polypropylene suture group and staple group was 46.75 years and 46 years, respectively. 80% (160 patients) in polypropylene suture group and 75% (150 patients) in stapler group had indirect hernia. The mean operative time in PPSG and SG group was 59.25 minutes and 45 minutes, respectively (p value<0.05), while as the mean hospital stay in the two groups was 1.5 days and 1.28 days, respectively, the difference however was statistically insignificant ( p value>0.05). Overall the complication rate was the same in the two groups with no statistically significant differences observed (P value >0.05). There was 0% recurrence rate in 6 months and 1 year of follow-up in both groups. However, in 3-year follow-up 20 patients (10%) in PPSG and 2 patients (1%) in SG had recurrence (P value=0.0001).
Conclusion: The technique of mesh fixation with skin staples is as effective as conventional fixation with polypropylene sutures, with an important added advantage of a significant reduction in the operative time and an early return to work. At the same time this technique does not have any additional complications compared to traditional Lichtenstein method. Good tissue penetrance and effective mesh anchorage are achieved when staples are utilized to secure the mesh.

Key words: Polypropylene suture, staple, mesh fixation


 
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Pubmed Style

Wani MUD, Mushtaq A, Bhat MY, Mir SA. A comparative study of skin staples versus sutures for fixing mesh in tension-free mesh hernioplasty. Arch Clin Exp Surg. 2018; 7(1): 7-12. doi:10.5455/aces.20170125125700


Web Style

Wani MUD, Mushtaq A, Bhat MY, Mir SA. A comparative study of skin staples versus sutures for fixing mesh in tension-free mesh hernioplasty. http://www.ejmaces.com/?mno=239326 [Access: August 17, 2018]. doi:10.5455/aces.20170125125700


AMA (American Medical Association) Style

Wani MUD, Mushtaq A, Bhat MY, Mir SA. A comparative study of skin staples versus sutures for fixing mesh in tension-free mesh hernioplasty. Arch Clin Exp Surg. 2018; 7(1): 7-12. doi:10.5455/aces.20170125125700



Vancouver/ICMJE Style

Wani MUD, Mushtaq A, Bhat MY, Mir SA. A comparative study of skin staples versus sutures for fixing mesh in tension-free mesh hernioplasty. Arch Clin Exp Surg. (2018), [cited August 17, 2018]; 7(1): 7-12. doi:10.5455/aces.20170125125700



Harvard Style

Wani, M. U. D., Mushtaq, A., Bhat, M. Y. & Mir, S. A. (2018) A comparative study of skin staples versus sutures for fixing mesh in tension-free mesh hernioplasty. Arch Clin Exp Surg, 7 (1), 7-12. doi:10.5455/aces.20170125125700



Turabian Style

Wani, Mumtaz Ud Din, Azher Mushtaq, Mohammad Yaqoob Bhat, and Shabir Ahmad Mir. 2018. A comparative study of skin staples versus sutures for fixing mesh in tension-free mesh hernioplasty. Archives of Clinical and Experimental Surgery (ACES), 7 (1), 7-12. doi:10.5455/aces.20170125125700



Chicago Style

Wani, Mumtaz Ud Din, Azher Mushtaq, Mohammad Yaqoob Bhat, and Shabir Ahmad Mir. "A comparative study of skin staples versus sutures for fixing mesh in tension-free mesh hernioplasty." Archives of Clinical and Experimental Surgery (ACES) 7 (2018), 7-12. doi:10.5455/aces.20170125125700



MLA (The Modern Language Association) Style

Wani, Mumtaz Ud Din, Azher Mushtaq, Mohammad Yaqoob Bhat, and Shabir Ahmad Mir. "A comparative study of skin staples versus sutures for fixing mesh in tension-free mesh hernioplasty." Archives of Clinical and Experimental Surgery (ACES) 7.1 (2018), 7-12. Print. doi:10.5455/aces.20170125125700



APA (American Psychological Association) Style

Wani, M. U. D., Mushtaq, A., Bhat, M. Y. & Mir, S. A. (2018) A comparative study of skin staples versus sutures for fixing mesh in tension-free mesh hernioplasty. Archives of Clinical and Experimental Surgery (ACES), 7 (1), 7-12. doi:10.5455/aces.20170125125700





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