A Comparative Study of Stapled Vs Subcuticular Vs Simple Interrupted Closure of Inguinal Hernia Incision

Abstract

Introduction:Hernia repair is one of the most common surgical procedure performed by general surgeons. With increasing knowledge about accelerated rehabilitation, the surgeons are under pressure to reduce the duration of hospital stay, due to which the method of skin closure has gained importance. The two main techniques of skin closure used by surgeons, are removable skin staples and skin sutures. We decided to study the various skin closure techniques in hernia surgery. Material and Method:The present study was a comparative study carried out at a tertiary care hospital over a period of two years. Total 90 patients of hernia were included in the present study. Patients were divided into 3 groups based on the method of skin closure applied. Main parameters investigated were postoperative pain, postoperative wound infection rates, cosmetic acceptability of scar and time required for skin closure. Statistical analysis was used wherever applicable. Results:The incidence of hernia is common in the younger age group, the mean age being in the 41years. The majority of cases were unilateral (right side); right sided indirect inguinal hernia was the most frequent type observed in this study. At 48 hrs both stapled and subcuticular group have comparable but not significant pain i.e. they experienced only mild, nagging pain. At discharge Subcuticular closure group has significantly less pain. At 48 hrs, highest wound infection rate was in subcuticular group (60%). 73.3%of patients having skin closure using stapler didn’t had any wound infection at 48 hrs. At time of suture removal, highest number of wound complication occur in subcuticular group. Conclusion:Subcuticular closure of inguinal skin incision gives best cosmetic scar to patients. Subcuticular skin closure technique is painless. Skin Stapler is most rapid method of skin closure. Least wound complications are with use of skin stapler.