A COMPARATIVE STUDY OF MESH FIXATION WITH POLYPROPYLENE (PROLENE) VERSUS POLYGLACTIN (VICRYL) SUTURES IN OPEN INGUINAL HERNIA REPAIR: AN OBSERVATIONAL STUDY

Abstract

Background: Mesh fixation is central to Lichtenstein tension-free hernioplasty, and the choice of suture material used for fixation, non-absorbable polypropylene (Prolene) versus absorbable polyglactin (Vicryl), may influence postoperative pain and complications. Aim: This study was intended to compare postoperative complications and pain outcomes between Prolene and Vicryl sutures used for mesh fixation in open inguinal hernia repair. Methods: It is a hospital-based observational study conducted over a period of 12 months in a tertiary care centre. A total of 106 patients undergoing open (Lichtenstein) inguinal hernia repair were allocated into two equal groups of 53 each according to the suture material used intraoperatively for mesh fixation. Operative time, hospital stay, postoperative pain on the Visual Analog Scale (day 1, 3, 7, and 1, 3, 6 months), and complications including seroma, hematoma, mesh infection, wound gap, urinary retention, foreign body sinus/fistula, and recurrence at 3 and 6 months were compared using independent-samples t tests and chi-square tests. Statistical significance was set at p < 0.05. Results: The two groups were comparable at baseline for age, sex, BMI, and defect size. Operative time was significantly longer with Prolene (65.89 ± 10.87 min) than Vicryl (59.76 ± 9.80 min; p = 0.003). Pain scores were significantly higher with Prolene on postoperative day 1 (p = 0.020) and remained higher at 1, 3, and 6 months, most markedly at 6 months (Prolene 1.58 ± 1.13 vs Vicryl 0.70 ± 0.64). Individual complications did not differ significantly between groups, but overall postoperative complication rate was significantly higher with Prolene (28.3%) than Vicryl (11.3%; p = 0.028), while short term recurrence was comparable. Conclusion: Vicryl sutures were associated with shorter operative time, lower early and long-term postoperative pain, and a lower overall complication burden than Prolene, without compromising short-term recurrence, supporting its consideration as a favourable alternative for mesh fixation in open inguinal hernia repair.