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At least 73 records · Page 4Linked to original sources
PubMed2005

Long-term anatomical and functional assessment of trans-vaginal cystocele repair using a tension-free polypropylene mesh.

We report a case series of 63 women with cystocele who underwent the same trans-vaginal procedure between October 1999 and October 2002. The polypropylene mesh (GyneMesh, Gynecare, Ethicon, France) was placed from the retropubic space to the inferior part of the bladder in a tension-free fashion. Patients were followed up for 24 to 60 months, with a mean follow-up of 37 months. Fifty-five patients returned for follow-up (87.3%). At follow-up, 49 women were anatomically cured (89.1%), five women had stage 2 anterior vaginal wall prolapse (9.1%), and one had a recurrent stage 3 (1.8%). Functional results and sexual function were also investigated. Fifty-three women had significant improvement in their quality of life (96.4%). There were a total of three cases of local pain around a mesh shrinkage (5.5%) and five vaginal erosions of the mesh (9.1%). Four out of 24 patients had dyspareunia (16.7%). In conclusion, the vaginal repair of anterior vaginal wall prolapse reinforced with a polypropylene mesh was efficient at 2 to 5 years follow-up. However, the first generation of polypropylene mesh we used was responsible for high rates of local complications and dyspareunia. Therefore, the polypropylene mesh has to be improved (lower weight) and the technique has to be documented by a randomized controlled trial before we could recommend its use in clinical practice.

Adult↗
PubMed2005

Acute inflammatory response after inguinal and incisional hernia repair with implantation of polypropylene mesh of different size.

BACKGROUND: The purpose of this study was to assess the modifications of interleukin (IL)-6, C-reactive protein (CRP), leukocytes and fibrinogen after implantation of polypropylene mesh. METHODS: Thirty-six patients were included in this study and divided into two groups. To the first group were allocated patients affected by inguinal hernia and undergoing conventional repair (subgroup Ia) or hernioplasty with 40-cm(2) polypropylene mesh (subgroup Ib). To the second group were allocated patients affected by incisional hernia and undergoing conventional repair (subgroup IIa) or incisional hernia repair with 400-cm(2) polypropylene mesh (subgroup IIb). Peripheral venous blood samples were collected 24 h before surgery and then 6, 24, 48 and 168 h postoperatively. RESULTS: We present evidence that serum levels of IL-6, CRP, leukocytes and fibrinogen were significantly increased postoperatively in all subgroups compared with their baseline values. In particular, the production of inflammatory mediators was higher in subgroups Ib vs Ia and IIb vs IIa. Comparing the entities of the inflammatory responses among various groups we found that it was clear that they were similar in subgroups Ib and IIa, and that the highest were in subgroup IIb and the lowest in subgroup Ia. CONCLUSION: The data show that conventional inguinal and incisional hernia repair induces an inflammatory response, which is smaller than that observed if both operations are carried out with polypropylene meshes. Furthermore, the results suggest that a larger mesh is associated with a higher production of inflammation mediators.

Biocompatible Materials↗
PubMed2004

Prevention of adhesion formation to polypropylene mesh by collagen coating: a randomized controlled study in a rat model of ventral hernia repair.

INTRODUCTION: In laparoscopic incisional hernia repair with intraperitoneal mesh, concern exists about the development of adhesions between bowel and mesh, predisposing to intestinal obstruction and enterocutaneous fistulas. The aim of this study was to assess whether the addition of a collagen coating on the visceral side of a polypropylene mesh can prevent adhesion formation to the mesh. METHOD: In 58 rats, a defect in the muscular abdominal wall was created, and a mesh was fixed intraperitoneally to cover the defect. Rats were divided in two groups; polypropylene mesh (control group) and polypropylene mesh with collagen coating (Parieten mesh). Seven and 30 days postoperatively, adhesions and amount and strength of mesh incorporation were assessed. Wound healing was studied by microscopy. RESULTS: With Parieten mesh, the mesh surface covered by adhesions was reduced after 30 days (42% vs 69%, p = 0.01), but infection rate was increased after both 7 (p = 0.001) and 30 days (p = 0.03), compared to the polypropylene group with no mesh infections. If animals with mesh infection were excluded in the analysis, the mesh surface covered by adhesions was reduced after 7 days (21% vs 76%, p = 0.02), as well as after 30 days (21 vs 69%, p < 0.001). Percentage of mesh incorporation was comparable in both groups. Mean tensile strength of mesh incorporation after 30 days was higher with Parieten mesh. CONCLUSION: Although the coated Parieten mesh was more susceptible to mesh infection in the current model, a significant reduction of adhesion formation was still seen with the Parieten mesh after 30 days, with comparable mesh incorporation in the abdominal wall.

Abdominal Wall↗
PubMed2005

Totally extraperitoneal inguinal hernioplasty with titanium-coated lightweight polypropylene mesh: early results.

BACKGROUND: This prospective study of a new titanium-coated low-weight polypropylene (PP) mesh (16 g PP/m2) was designed to investigate the clinical efficacy and safety of totally extraperitoneal endoscopic hernioplasty (TEP). METHODS: In this study, 400 patients (average age, 53.5 years; range, 19-80 years) with a total of 588 inguinal hernias underwent surgery with the TEP technique between September 2002 and October 2003. Of these patients, 12.4% had experienced recurrent hernias after open suture herniotomy. In 92% of the cases (368 patients with 540 hernias), a lightweight (16 g PP/m2) titanium-coated polypropylene mesh was implanted without fixation, and in 8% (32 patients with 48 hernias) an identical medium-weight (35 g PP/m2) mesh was implanted. The first follow-up examination was scheduled for postoperative week 6. RESULTS: In the lightweight mesh group, the mean group, operating time per patient was 61 min, corresponding to a calculated time per hernia of 41 min. Two intraoperative major complications occurred: an injury to the cecum and an injury to the bladder. In 12 cases (2%), bleeding from epigastric, testicular, or pubic bone vessels was observed. No injuries to pelvic vessels were seen. One patient was underwent an endoscopic revision to deal with an anticoagulation-related bleed. The mortality rate was 0%. In 12 patients, postoperative hematomas developed. One preperitoneal lipoma had to be extirpated. No infections of the mesh occurred. The median follow-up period for 371 patients (92.3%) was 7.2 weeks (range, 4-14 weeks). These 343 patients (with 504 hernias) had been provided with a lightweight titanium-coated polypropylene mesh (16 g PP/m2) (follow-up rate, 93.2%). Of these patients, 3.5% reported persistent ingunial pain, 1.7% described a sensation of rigidity in the region of the groin, and 3.2% reported dysesthesia. The early recurrence rate was 0.2%. CONCLUSIONS: The TEP procedure can be performed safely and effectively with the appreciably material-reduced and titanium-coated polypropylene mesh without the need for fixation of the implant. The low early recurrence rate of 0.2% is evidence that the posterior wall of the inguinal canal is adequately augmented. The question whether the material reduction and the titanium coating of the mesh may bring about a reduction in postoperative chronic pain and the sensation of rigidity in the inguinal area via an improvement in biocompatibility must await the results of the scheduled follow-up examination 1 year after the surgical procedure.

Adult↗
PubMed2004

Titanium coating of a polypropylene mesh for hernia repair: effect on biocompatibilty.

Titanium and its alloys are used worldwide in surgery. The favorable characteristics that make this material desirable for implantation are corrosion resistance and biocompatibility. Concerning hernia repair, a mesh modification has been developed using titanium layering of a polypropylene mesh implant, which is said to lead to an improved biocompatibility compared to commercially available mesh materials. To analyze the pure effect of titanium coating, two different mesh structures were studied using a standardized animal model. The titanium-coated monofilamentous, large porous, and lightweight mesh made of polypropylene and coated with titanium (PP+T) was compared to a pure polypropylene mesh manufactured with a similar structure and amount of material serving as a control (PP). In Sprague-Dawley rats, mesh samples were placed in a subcutaneuous position. Then 56, 84, and 182 days after mesh implantation, three animals from each group were sacrificed for morphological observations (amount of inflammatory and connective tissue formation, percentages of proliferating and apoptotic cells, percentage of macrophages). Both mesh modifications investigated showed an overall good biocompatibility. Macroscopic clinical observation after implantation of up to 182 days was uneventful. The tissue response to the PP as well as to the PP+T mesh was characterized by a moderate inflammatory tissue reaction limited to the perifilamentary region as is known for low weight, large porous, and monofilamentous mesh structures. No significant improvement of biocompatibility was found when analyzing the effect of titanium coating compared to the pure polypropylene mesh structure.

Animals↗
PubMed2005

Influence of polyglecaprone 25 (Monocryl) supplementation on the biocompatibility of a polypropylene mesh for hernia repair.

BACKGROUND: Supplementary polyglecaprone 25 (Monocryl) monofilaments were added to a lightweight pure monofilament polypropylene mesh (PP mesh) to improve intraoperative handling (PP+M mesh). This study was designed to evaluate the influence of this additional supplementation on the biocompatibility in a rodent animal model. METHODS: Two mesh materials, a composite mesh (PP+M) and the pure polypropylene variant (PP), were compared after subcutaneous implantation in a standardized rat model. Histological analysis of the inflammatory response was performed after 28, 56 and 84 days of implantation. Material absorption, inflammatory tissue reaction, fibrosis and granuloma formation were investigated, as well as the percentage of proliferating and apoptotic cells at the interface. RESULTS: Both mesh materials showed a slight foreign body reaction involving mainly macrophages and foreign body giant cells. Total absorption of the Monocryl filaments of the PP+M mesh occurred between 56 and 84 days of implantation. Both the inflammatory and the fibrotic reaction were decreased (n.s.) in the PP+M mesh group compared to the pure PP mesh. Whereas the percentage of proliferating cells showed no significant difference, the rate of apoptotic cells was significantly decreased in the PP+M mesh group over the whole implantation period. CONCLUSION: Compared to the pure polypropylene mesh, our data confirm that the use of a polypropylene mesh supplemented with absorbable Monocryl filaments is feasible without additional short-term mesh-related complications in the experimental model or negative side effects on biocompatibility.

Animals↗
PubMed1992

Pulmonary toxicity of inhaled polypropylene fibers in rats.

This study was initiated to assess the pulmonary toxicity of a polyolefin fiber composed of polypropylene in male Fischer 344 rats after 90 days of inhalation exposure. To increase fiber respirability in the rodent, polypropylene fibers were size-selected before aerosolization to have a geometric mean diameter of 1.6 microns (46% < 1 micron) and a geometric mean length of 30.3 microns. Three groups of animals were exposed in nose-only inhalation chambers, 6 hr/day, 5 days/week, for 90 days to 15, 30, or 60 mg/m3 of polypropylene, or filtered air (negative control). Microscopic examination of the polypropylene fiber-exposed lungs revealed that, at all time points examined in the study, there was a dose-dependent increase in pulmonary macrophages. These minimal or mild increases in cellularity appeared to be reversible, especially at the lower doses 30 days post exposure. No fibrosis was observed in any of the groups. A strong correlation was found between the external exposure concentration, the time of exposure, and the lung fiber burden. The number of partially degraded (segmented) fibers within the lung increased with the exposure concentration and period of exposure, as well as with the period of recovery after termination of exposure at 90 days. Fibers were recovered from exposed lungs using a hypochlorite digestion technique.

Administration, Inhalation↗
PubMed2005

Comparison between monofilament and multifilament polypropylene tapes in urinary incontinence.

OBJECTIVE: We compare the efficacy and late complications between a polypropylene monofilament tape (TVT) and a polypropylene multifilament tape (IVS) in the surgical implant of sub-urethral, tension free tape for the treatment of stress urinary incontinence (SUI). METHODS: It is a non-randomised, monocentric retrospective study. Two questionnaires were sent to the patients. The first questionnaire determined the efficacy of the tape and the tolerance of the urinary process. The second questionnaire evaluated discomfort and consequences linked to urinary incontinence and associated urinary troubles. RESULTS: The study included 313 female patients and 256 (82%) responded to the questionnaire (137 TVT, 119 IVS). Patient satisfaction was 88.3% for the TVT tape and 73.5% for the IVS tape (p < 0.005). The improvement of the quality of life was also higher for the polypropylene monofilament tapes. "De novo" urge incontinence was more common in the TVT group. However, the rates of dysuria and infection of tapes were more common in the IVS group. CONCLUSION: The type of tape appears to influence efficacy and the emergence of late complications. Our results point at the greater efficacy of the polypropylene monofilament tape.

Aged↗
PubMed2004

Erosions and urinary retention following polypropylene synthetic sling: Australasian survey.

INTRODUCTION: There are few published reports on the incidence and management of urethral and vaginal erosions following the use of polypropylene synthetic slings. Moreover, there is very little Australasian data on their use for management of female urinary incontinence or on their associated complications. METHODS: A 1-page survey was mailed to the Australian and New Zealand members of the Urological Society of Australasia (N=326). The survey included questions on the use of polypropylene synthetic sling and the incidence and management of post-operative vaginal and urethral erosions and urinary retention. RESULTS: 198 surveys were returned (response rate: 61%). Polypropylene synthetic sling procedure is practiced by 39% of the respondents with a total of 1459 cases (TVT: 993, SPARC: 466). The incidence of vaginal erosions, urethral erosions and urinary retention was 1.2%, 0.6% and 6.5%, respectively. Thirty five percent of vaginal erosions were asymptomatic and only identified on routine post-operative vaginal examination. One third of urethral erosions presented more than 1 year after surgery and 89% of these were symptomatic. Thirty four percent of patients with urinary retention required surgical intervention to correct the retention. CONCLUSIONS: The incidence of urethral and vaginal erosions following polypropylene synthetic sling procedures is lower than that with other synthetic slings. However, a high index of suspicion and long-term follow-up are required to identify and manage these complications of this relatively new procedure.

Australia↗
PubMed2005

Impact of vaginal surgery for stress urinary incontinence on female sexual function: is the use of polypropylene mesh detrimental?

OBJECTIVES: To evaluate prospectively the impact of a distal urethral polypropylene sling on sexual function using a validated questionnaire. Suburethral slings are currently the most common anti-incontinence surgery performed. Although the use of polypropylene is safe and effective, concern exists that the presence of the material in the vagina may adversely affect sexual function. METHODS: A total of 29 patients agreed to participate in this prospective study. The patients were evaluated with the Female Sexual Function Index, a validated, 19-item questionnaire that assesses six domains of sexual function: desire, arousal, lubrication, orgasm, satisfaction, and pain. The questionnaires were administered at 6-month intervals during the follow-up visits. RESULTS: The mean patient age was 52 years (range 38 to 72). The mean duration of follow-up was 19.4 months (range 7 to 37). No statistically significant difference was found in sexual function after placement of a distal urethral polypropylene sling. Of the 29 patients, 14% were not sexually active before or after surgery. No statistically significant difference was found between preoperative and postoperative desire, arousal, lubrication, orgasm, satisfaction, and pain. CONCLUSIONS: No change was found in overall sexual function in women undergoing placement of a mid to distal polypropylene urethral sling. Specifically, neither a deleterious effect nor statistically significant improvement was found in sexual desire, arousal, lubrication, orgasm, satisfaction, or pain compared with the preoperative baseline values.

Adult↗
PubMed2005

Is polypropylene mesh safe and effective for repairing infected incisional hernia in renal transplant recipients?

INTRODUCTION: Infected incisional hernias are common in kidney transplant patients. Treating them in immunosuppressed patients can take months, increasing costs and implying loss of working productivity. Abdominal wall prostheses have not been used in infected immunosuppressed patients because of poor infection control. We evaluated the outcome of the surgical treatment of these patients with polypropylene mesh to shorten the hospitalization time and patient recovery. The records of 462 consecutive kidney transplant patients (March 2000 to February 2004) were reviewed. Of these 462 patients, 13 (2.8%) had infected or contaminated herniations at the transplant incision. They developed between 2 and 60 days (mean 14) after transplantation. The racial distribution was not significant, but herniations were more common in patients from cadaveric donors (4.5% versus 0%, P = 0.005). Predisposing factors were found in 6 patients (46.2%) and included complications from transplant surgery in 2, obesity in 1, leukopenia in 3, sepsis in 1, diabetes mellitus in 1, and wall weakness in 1 patient (3 had more than one risk factor). TECHNICAL CONSIDERATIONS: A prospective protocol of surgical correction with polypropylene mesh was established. After wound cleansing with normal saline, repair was done by primary fascial approximation and polypropylene mesh reinforcement. Broad-spectrum antibiotics and large-bore drains were used. Follow-up ranged from 1 to 40 months (mean 14.5). All patients did well except for one recurrence, 14 months after correction. CONCLUSIONS: Surgical repair with polypropylene mesh is safe and effective in treating infected or contaminated herniations in kidney transplant patients, with an acceptable (9.1%) incidence of recurrence.

Adolescent↗
PubMed1996

Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh.

BACKGROUND: Incisional hernia is a serious complication of abdominal surgery. We compared incisional hernia frequency following gastric bypass (GBP) for morbid obesity versus total abdominal colectomy and ileal pouch-anal anastomosis (IPAA) for ulcerative colitis. A prefascial polypropylene mesh repair was also evaluated. PATIENTS AND METHODS: All patients had midline incisions, xiphoid to umbilicus in GBP patients and midepigastrium to pubis in IPAA patients. Fascia were closed with running No. 2 polyglycolic acid suture. Ninety-eight patients underwent prefascial polypropylene mesh repair; 80 were GBP patients, 46 had 1 previous repair, and 17 had 2 to 9 previous repairs (6 with properitoneal mesh). RESULTS: Incisional hernia occurred in 20% (198/968) of GBP patients (19% without versus 41% with a previous hernia, P < 0.001) versus 4% (7/171) of the IPAA patients (P < 0.001), of whom 102 (60%) were taking prednisone (32 +/- 2 mg/d) and 5 were quite obese (body mass index > or = 30 kg/m2). Additional risk factors for hernia in GBP patients included wound infection, diabetes, sleep apnea, and obesity hypoventilation. For the 98 patients who underwent prefascial polypropylene mesh repair, the mean follow-up was 20 +/- 2 months (range 6 to 104), and complications occurred in 35% of patients, including minor wound infection (12%), major wound infection (5%), seroma (5%), hematoma (3%), chronic pain (6%), and recurrent hernia (4%). CONCLUSIONS: Severe obesity is a greater risk factor for incisional hernia and hernia recurrence than chronic steroid use in nonobese colitis patients. A prefascial polypropylene mesh repair minimizes recurrence.

Abdomen↗
PubMed1995

Polypropylene mesh closure of the complicated abdominal wound.

BACKGROUND: Closure of the abdominal wall in the face of fascial necrosis or massive intestinal edema remains a difficult problem with frequent complications. Prior studies have addressed both the utility and the pitfalls of placing polypropylene mesh in this setting. METHODS: We performed a retrospective evaluation of our experience with polypropylene mesh in traumatic and nontraumatic difficult abdominal closures. Timing of mesh placement and removal relative to the initial operation were recorded, as were abdominal complications, number of operative procedures, and type of ultimate abdominal closure. RESULTS: Between 1988 and 1993, polypropylene mesh was placed in 26 critically ill or injured patients requiring celiotomy, of whom 23 survived more than 3 weeks. Ultimate wound management was delayed mesh removal and primary closure (17%), myocutaneous flap coverage over mesh (4%), split-thickness skin grafting to the granulating wound (35%), or closure by secondary intention over mesh (43%). Split-thickness skin grafting and closure by secondary intention resulted in enterocutaneous fistulas in 50% and 40% of cases, respectively. Full-thickness closure with or without mesh removal resulted in no fistulas. CONCLUSION: Mesh provided adequate fascial closure, even with gross wound contamination. Coverage of polypropylene mesh by secondary intention or split-thickness skin grafting resulted in unacceptably high rates of fistulous complications, and this procedure should be replaced by either mesh removal or full-thickness coverage.

Abdominal Injuries↗
PubMed1983

Effect of ultraviolet radiation (300-400 nanometers) on polypropylene.

Polypropylene discs and shavings were exposed to simulated ambient ultraviolet (UV) radiation (lambda 300-400 nm) for a period equivalent to at least two years of wear within the eye, assuming the eye to be exposed to ambient UV radiation for four hours per day at 1 mW/cm2. The polypropylene and the incubation media were measured by several forms of optical spectroscopy, and there was no photochemical change in either. Where polypropylene discs were exposed to a very high level of UV radiation (greater than 500 W/cm2), they became brittle and discolored within five to ten days. This level of exposure, however, was equivalent to a total of over 20 million joules/cm2, which is at least one million times levels for expected ambient UV exposure to polypropylene within the eye.

Dose-Response Relationship, Radiation↗
PubMed1983

Estimation of the useful lifetime of polypropylene fiber in the anterior chamber.

A study of the stability of polypropylene fiber, size 4-0, to ultraviolet light was performed. Samples were radiated in physiological saline solution at 35.5 +/- 1.5 degrees C using a xenon-arc lamp at an intensity of 650 milliwatts per square centimeter. The light was filtered to remove wavelengths below 300 nanometers and thus simulated transmittance of the cornea. Tensile strength, elongation and modulus, and the surface morphology of the fiber by scanning electron microscopy (SEM) were determined as a function of exposure time. The average ultraviolet (UV) light intensity which irradiates the eye was determined from available meteorological data and was used to calculate human exposure at various geographical locations. This information along with the light energy of the xenon-arc lamp was used to calculate the useful lifetime of polypropylene fiber in the anterior chamber. Using an average exposure of 2.2 hours per day for a 60-year-old implant recipient, the useful lifetime ranges from 53 years in Miami, Florida, to 75 years in Seattle, Washington. Polypropylene loops from lenses which had been implanted in human eyes for up to 4.8 years showed no molecular degradation as compared to control material. Polypropylene fiber is therefore safe for use in anterior chamber implants.

Anterior Chamber↗
PubMed2006

[Treatment of genital prolapse with a polypropylene mesh inserted via the vaginal route. Anatomic and functional outcome in women aged less than 50 years].

OBJECTIVES: We evaluated the results of surgical insertion of a polypropylene mesh via the vaginal route in young women presenting genital prolapse. MATERIAL AND METHODS: Retrospective study concerning 20 women under age 50 who underwent between July 2000 and December 2003 surgical insertion of an anterior (n=14), posterior (n=3) or double (anterior and posterior) (n=3) polypropylene mesh via the vaginal route. A minimum follow-up of 6 months was required for inclusion in the study. Anatomical results were assessed using the Pelvic Organ Prolapse Quantification (POP-Q) according to ICS (International Continence Society) recommendations. To document the functional results, the patients answered 3 validated self-assessment questionnaires related to pelvic symptoms, sexual behaviors and quality of life. RESULTS: Mean follow-up was 21 months (6 to 52 months). A vaginal erosion of the mesh occurred in 2 women (10%). Cystocele recurred in one woman among the 17 patients who had an anterior polypropylene mesh (Gynemesh, Gynecare, Ethicon). Seventeen women were sexually active before the surgical procedure and 19 post-operatively. Among these women, 5 (26%) reported alteration of sexual activity after surgery (with dyspareunia in 4 cases (21%)), and 14 women (74%) reported no changes or improvement in sexual activity. CONCLUSION: Surgical management of genital prolapse using a polypropylene mesh inserted via the vaginal route has proven its anatomical efficacy in young women. The potential adverse consequences on sexual life would require clinical research concerning the surgical approach (abdominal or vaginal route) and synthetic materials used in prolapse surgery for young women.

Adult↗
PubMed1996

Elastic polypropylene suture in cataract surgery: long-term follow-up.

The final part of a prospective, controlled study of elastic polypropylene suture for cataract surgery was undertaken. The aim was to determine the change in induced astigmatism at 30 months after extracapsular cataract surgery and to assess the long-term safety of the suture material. Thirty-two of 44 patients were reexamined for changes in astigmatism. The results of all examinations were subjected to vector analysis. Both the elastic polypropylene group and the nylon control group continued to show an increase in the against-the-rule component of astigmatism. There was no statistical difference (p < 0.5) between the two groups at 30 months post-operatively, though the shift was greater in the polypropylene group. Wound security was similar for both groups but the polypropylene group had a higher incidence of giant papillary conjunctivitis (24%) due to exposed suture ends. The nylon suture was hydrolysed in 89% of that group and all patients were asymptomatic.

Aged↗
PubMed1998

Prospective randomized controlled trial to compare skin staples and polypropylene for securing the mesh in inguinal hernia repair.

BACKGROUND: The Lichtenstein tension-free repair has become the standard method for repairing inguinal hernia in many surgical units. This study compared two methods of mesh fixation. METHODS: Fifty men undergoing unilateral primary Lichtenstein inguinal hernia repair under general anaesthesia were randomized into two groups. In the control group polypropylene mesh was secured with 2/0 polypropylene sutures and the skin closed with subcuticular 3/0 polydioxanone. In the study group polypropylene mesh was secured with skin staples and the skin was closed with staples from the same staple gun. Duration of the operation was recorded. Early follow-up was achieved by patient review at 6 weeks and postal questionnaire at 12 weeks. RESULTS: The operation was significantly shorter when staples were used (median 20 min 0 s versus 29 min 30 s, P < 0.001). There was no significant difference in the incidence of postoperative complications or pain score. The study group reported earlier return to normal activity (4 weeks 0 days versus 6 weeks 2 days, P < 0.01) although there was no difference in the time taken to return to work or driving. CONCLUSION: The use of skin staples to secure mesh in the Lichtenstein inguinal hernia repair significantly reduced the duration of the operation and was as effective as conventional mesh fixation with polypropylene in the short term.

Adolescent↗