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East and Central African Journal of Surgery

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Evaluation of Tissue Adhesive as Alternative To Conventional Closure Methods in Inguinal Hernia Repair

AR Bansal, OP Saini, MS Griwan, YR Karthikeyan

Abstract


Background: Goals of wound closure should be achieved with a simple rapid and cost effective. Use of surgical adhesives can simplify skin closure in that certain problems inherent to suture use can be avoided.
Methods: To assess effectiveness of tissue adhesive in comparison to subcuticular 3-0 vicryl sutures in closure of inguinal hernia repair with respect to, time required for closure of skin incision, postoperative complications like wound disruption, wound discharge, wound infection and scar osmesis. The study was carried out on 50 patients of inguinal hernia (either direct or indirect) divided into group A tissue adhesive
and group B subcuticular vicryl of 25 each.
Results: Mean wound closure time in group A was 244+8.20 whereas mean wound closure time in group B was 391+29.72. A total of three patients had wound disruption in group A while none of the patients in group B had wound disruption. Wound discharge was present in 6 out of 25 (24%) cases in group A while only 2 out of 25 (8%) cases had wound discharge in group B. This difference in wound discharge was also found to be statistically significant (P<0.001). Wound infection in form of seropurulent discharge was observed in only one (4%) patient of the tissue adhesive group. One out of 20 (5%) cases had poor overall appearance of wound in group A and none of the cases had poor overall appearance of wound in group B.
The difference between overall appearances of wound in both the groups when compared statistically was found to be insignificant (p>0.05).
Conclusion: In the present study, although tissue adhesive offered a significantly faster closure than a running subcuticular 3-0 vicryl suture, there was no significantly different result in cosmesis.



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