Comparison of skin closure technique with stapler and subcuticular suture in patients with inguinal hernia undergoing lichtenstein tension-free mesh repair – An open-label randomized controlled trial

Abstract

Background: Both subcuticular suturing and stapler closure are used for skin closure. However, the superiority of one over the other is yet to be established clearly. Aims: This study compares the efficacy of skin closure technique by stapler and subcuticular suture in patients undergoing Lichtenstein repair for inguinal hernia. Methods: Elective inguinal hernia repair patients were randomized to undergo skin closure using either subcuticular sutures or staplers. Skin closure time in minutes, postoperative wound site pain using the Visual Analog Scale, wound cosmesis and scar outcome using the Patient and Observer Scar Assessment Scale, and patient satisfaction using the Likert scale were assessed. Results: A total of 38 patients with inguinal hernia were included: 20 in subcuticular suture group and 18 in stapler group. The scar outcomes assessed by patients (3.05 ± 1.83 vs. 4.94 ± 2.54; P = 0.0013) and observers (2.83 ± 0.98 vs. 4.44 ± 1.67; P = 0.0105) were significantly better in the subcuticular group. The time taken for skin closure was significantly longer in the suture group (P < 0.001). There was no significant difference between the two groups in terms of postoperative wound pain (P = 0.65), patient satisfaction (P = 0.238), and outcome of wound healing (P = 0.900). Conclusion: The cosmetic outcome of skin closure with subcuticular suture was better. Time taken for skin closure using staplers was shorter compared to suturing. Postoperative wound pain, patient satisfaction, and wound healing were similar between the two groups.

Keywords

• patient satisfaction
• postoperative wound pain
• skin closure
• visual analog scale
• wound cosmesis