This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Influence of suture material and surgical technique on risk of reoperation after non‐mesh open hernia repair. BJS 2003; 90: 1004-1008.
Published: 1st August 2003
Authors: P. Nordin, S. Haapaniemi, A. Kald, E. Nilsson
Background
Although mesh techniques are used with increasing frequency, sutured repair still has a place in groin hernia surgery. Studies relating suture material to recurrence rate have yielded conflicting results. The aim of the present study was to analyse the influence of suture material and sutured non‐mesh technique on the risk of reoperation in open groin hernia repair using data from the Swedish Hernia Register.
Method
The relative risk of reoperation after sutured repair using non‐absorbable, late absorbable and early absorbable sutures was compared in multivariate analyses, taking into account known confounding factors.
Results
Between 1992 and 2000, 46 745 hernia repairs were recorded in the Swedish Hernia Register. Of these, 18 057 repairs were performed with open non‐mesh methods and were included in the analysis. Using non‐absorbable suture as reference, the relative risk of reoperation after repair with early absorbable suture and late absorbable suture was 1·50 (95 per cent confidence interval (c.i.) 1·22 to 1·83) and 1·03 (95 per cent c.i. 0·83 to 1·28) respectively. Using the Shouldice repair as reference, other sutured repairs were associated with a significantly higher relative risk of reoperation (1·22, 95 per cent c.i. 1·03 to 1·44).
Conclusion
A non‐absorbable or a late absorbable suture is recommended for open non‐mesh groin hernia repair. The Shouldice technique was found to be superior to other open methods. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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