Jawwad Azeem Khan, Syed Imaduddin, Rahila Razzak, Siraj Haider, Junaid Zaman.
Darning versus mesh repair for inguinal hernia: When do patients return to normal physical activity?.
Pak J Surg Jan ;31(3):173-8.

Introduction: With the advent of newer methods for inguinal hernia repair like laparoscopy and mesh, older techniques like darn repair have gone into the background. However in our region where cost eff ectiveness is the prime concern, darn repair still enjoys a good reputation and popularity for the repair of inguinal hernia. Th is study was carried out to compare darn repair with Lichtenstein repair in terms of early return to work and normal physical activity. Sett ing and duration: Department of Surgery Unit IV, Civil Hospital Karachi from December 2009 to May 2013. Methodology: Th is is a randomized control trial study. Th e representative samples were taken from the male population with inguinal hernia presenting electively in the outpatient department of Civil Hospital Karachi. Equal number of patients (63 in each group) were selected and randomly assigned to both type of repairs; group A Darning and group B Lichtenstein (Mesh) Repair. Cases were followed on monthly basis for three months and three monthly till ninth month. Duration of stay and early postoperative complications like post operative pain, swelling, surgical site infection along with pain free early return to normal physical activity and work were recorded. Results: A total of 126 patients were divided into two groups, each of 63 patients. Group A had darns repair while group B had Lichtenstein mesh repair. Th ere was signifi cant diff erence in post-operative complications between two groups. In Group A (Darn repair) wound site scrotal swelling was seen in three patients. In Group B (Lichtenstein) wound site or scrotal swelling was in eight patients, while wound infection was seen in only one patient which required drainage and a formal course of injectable antibiotics for 5 days accompanied with dressings for one week. Patient was hospitalized for 5 days and discharged aft er complete wound healing took place on twelft h day. Above mentioned complications were associated with signifi cant post-operative pain and discomfort thus limiting the mobility and early return to work. Th us darn repair was found to be a bett er option of the two open repair techniques. Conclusion: Th is study shows post-operative early return to activity in patients who had darn repair because of reduction in post-operative complications. It concludes that darn repair is the bett er option than Lichtenstein repair.

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