title: Sutureless fixation with fibrin glue of lightweight mesh in open inguinal hernia repair: effect on postoperative pain: a double-blind, randomized trial versus standard heavyweight mesh.
abstract: BACKGROUND
  Open inguinal hernia repair is associated with a low incidence of complications that can be influenced by the type of mesh and its method of fixation. Our aim was to investigate the frequency and severity of postoperative pain and other complications when lightweight, large-pore meshes, compared with heavyweight, small-pore meshes, are fixed with human fibrin glue (HFG) during open inguinal hernia repair.
  
  
  METHODS
  A cohort of 80 patients undergoing open inguinal repair were enrolled. Forty patients received a lightweight and large porous mesh and 40 a standard heavyweight mesh with small pores. In all patients, HFG was used for mesh fixation.
  
  
  RESULTS
  Patients who received lightweight, large-pore mesh reported less pain than those in the control group both postoperatively (2.8 ± 1.1 vs. 4.9 ± 1.1; P = .0003) and at 1-month follow-up (1.7 ± 1.0 vs. 3.1 ± 1.0; P = .0038), and took fewer analgesics. There was no difference in days off work/activity. No differences were observed concerning postoperative complications. After 6 months there was no difference in groin pain between groups.
  
  
  CONCLUSIONS
  Patients who underwent open inguinal hernia repair with lightweight, large-pore mesh fixed with HFG experienced less pain throughout the first month after operation compared with those receiving standard mesh.
authors.affiliation: Unit of General and Geriatric Surgery, School of Medicine, Department of Surgery, Second University of Naples, Italy. silvestro.canonico@unina2.it
authors.forename: Silvestro
authors.initials: S
authors.lastname: Canonico
authors.forename: Raffaella
authors.initials: R
authors.lastname: Benevento
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Perna
authors.forename: Raffaella
authors.initials: R
authors.lastname: Guerniero
authors.forename: Guido
authors.initials: G
authors.lastname: Sciaudone
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pellino
authors.forename: Antonio
authors.initials: A
authors.lastname: Santoriello
authors.forename: Francesco
authors.initials: F
authors.lastname: Selvaggi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D015718:Fibrin Tissue Adhesive; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011446:Prospective Studies; D012720:Severity of Illness Index; D013526:Surgical Mesh; D014014:Tissue Adhesives; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives