Tariq Saeed Akhunzada, Wefaq Ullah, Tamjeed Gul, Rooh-ul muqim, Mohammad Aziz Wazir.
Lichtenstein mesh hernioplasty: an experience in teaching hospital.
Pak J Surg Jan ;28(2):98-101.

Objective: To clinically study and evaluate the results of Inguinal Hernioplasty in terms of wound infection, seroma, Haematoma- formation and recurrence. Design & Duration: Prospective case control study was conducted from Jan. 2010 to June 2011 in surgical “A” unit, Khyber Teaching Hospital. Patients: All male patients above 19years of age with Inguinal hernia were included in the study. Patients less than 19 years of age and those presenting in emergency were excluded from the study because they were not undergone Mesh Hernioplasty. Methodology: Patients with chronic cough, constipation, anamia, diabetes mellitus and hypertension, were pre-operatively managed and optimized. Anesthesia fi tness was taken aft er necessary investigations. Th ose patient not fi t for general anesthesia were operated on spinal and local anesthesia. Two doses of 2nd generation cephalosporin or Co-amoxiclave were used as prophylactic antibiotic. One injection of antibiotic in powder form is sprayed over the Mesh during operation. Data was collected on pre-designed proforma. Post operative follow up was done for 6 months. Results: A total 100 males and 104 hernias were operated during this study. 65% of patients had right side hernia, 31% had left side hernia and 4% had bilateral inguinal hernias. 88% inguinal hernias were reducible and 12% were irreducible, while 8% were recurrent. Th e ages of the patient ranges from 19 years to 80 years. Most of the patient, 72% were under 60 years of age. Mean Age : 49.63+-14.10. 60% of the patients were manual workers. i.e. 28% heavy manual workers and 32% light manual workers. wound infection occurred in 5% cases, urinary retention is 5%, heamatoma is 7% and seroma 12%, while 1% recurrence in 100 patients(0.96% recurrence in 104 hernias) and no mortality occurred during the study. Conclusion: It was proved that mesh hernioplasty for inguinal hernias was eff ective with lower complications, recurrence and low morbidity while no mortality. It was easy to learn with early mobilization of patients and early start to work. Although the cost of the mesh was slight burden on the patients but when compared with results it was more cost-eff ective.

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