New Indian Journal of Surgery

The quality of skin wound healing can be improved by the application of collagen scaffolds as biological dermal substitutes. Dermal extract helps to improves wound healing and quality of the scars. They serve as a scaffold into which cells can migrate and repair the injury. In the current scenario where in many biological and cellular engineering skin substitutes are available, wound management is a multimodality treatment with use of multiple available methods to augment wound healing at various levels. In this article we have described the role of dermal extract with collagen scaffolding in management of post burn raw area.

Scrotal calcinosis is a rare benign condition with painless slow growing nodular masses within the dermis of the scrotal skin. It was fi rst described by Lewinskey in 1883. Deposition calcium in the skin, subcutaneous tissue, muscles, and visceral organs is known as calcinosis, and it more common involves skin and it is called calcinosis cutis. There are four types of calcinosis cutis based on their etiology  such as dystrophic, metastatic, iatrogenic, and idiopathic. Idiopathic scrotal calcinosis cutis is a rare benign lesion. Metabolic and hormonal work-up is required to rule out other causes. Irrespective of the etiology, surgical excision is required both for confi rming the diagnosis as well as for treatment. The surgical excision should be based on the extent of the nodules and must include even the smallest nodules to avoid rapid recurrence.

Surgical site infections (SSIs) are the leading type of infection among hospitalized patients.Careful handling of the surgical equipments reduces the chances of surgical site infections,& those who incorporate best practice standards can reduce the morbidity & mortality associated with SSIs.The purpose of the research was to find out the efficacy of prophylactic antibiotics & how surgical site infections arise. Postoperative surgical site infections (SSIs) remain a major source of illness & morbidity in  surgical patients. These infections number approximately 500000 per year, among an estimated 27 million surgical procedures, & account for approximately one quarter of the estimated 2 million nosocomial infections each year. This study focuses on the prophylactic antibiotics given before surgery, and also compares it with conventional post operative antibiotic treatment. Study would also consider,if one can dispense the use of conventional post operative antibiotics, if the efficacy of prophylactic antibiotics is significant.

Management of blunt injury to the spleen in adults has been applied with increasing frequency. The purpose of this multi-institutional study was to determine which factors predict successful observation of blunt splenic injury in adults. The spleen is the most frequently injured organ following blunt abdominal trauma.Prompt recognition and appropriate scoring of splenic injury is vital for preventing the potentially disastrous complication of hemorrhage and hypovolemic shock. However, due to the well-recognized risks for post-splenectomy sepsis,routine splenectomy for injury has given way to the practice of splenic salvage, utilizing techniques of splenorrhaphy (repair of splenic laceration or rupture with sutures), nonoperative management of solid organ injury, and angiography with embolization, either singularly or in combination. We used the American Assoication for the surgery of trauma Classification for splenic injury.

Introduction: Breast cancer is the commonest cancer in Indian female population. India faces a potential breast cancer epidemic over the next decade as women adopt western lifestyles by marrying and bearing children later in life. An emerging literaturesupports hemostatic elements as an important patientfactor that facilitates the metastatic potential of breastcancer including platelets, coagulation, and fibrinolysis. Hence this study was taken up to assess the coagulation abnormalities in patients of breast cancer.

Materials and Methods: The study was a prospective, case control study carried out with patients presenting with complaints of lump in the breast which were later confirmed to be malignant after triple assessment. Data was collected by history taking, physical examination, haematological investigations including coagulation profile, imaging tests (mammogram, ultrasound and/or MRI), andFNAC
or core needle biopsy.

Results: Platelet count, Bleeding and clotting times, PT, INR, APTT and fibrinogen were found to be  comparable in patients with breast cancer when compared with controls. D-Dimers were found to be significantly elevated (odds ratio = 10.54, p = 0.03) in patients with breast cancer when compared with controls. D-Dimers were elevated in cases with locally advanced and advanced breast carcinomas.

Conclusion: Locally advanced and advanced breast carcinomas may present with an elevated levels of d-dimers indicating a compensated state of DIC.Detection of D-Dimers may offer a differential analysis over other laboratory tests for DIC. 

Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing, fibrohistiocytic neoplasm with intermediate-to low-grade malignancy that commonly favors young to middle-aged adults. It is most commonly seen on the trunk followed by the proximal extremities and the head and neck [1,2]. The potential for distant metastasis is low, but DFSP frequently recurs locally after incomplete excision. The general immunostaining pattern of DFSP is CD34 positive and factor XIIIa negative. Mohs micrographic surgery (MMS) is the treatment of choice for DFSP. Presenting a study of five cases of Dermatofibrosarcoma protruberans which were admitted to our hospital during the period of two years from Jan 2015 to December 2016. All five patients presented with large irregular growths over the body, slow-growing and accompanied with itching and bloody discharge. Four out of five were males and one patient was female. All five patients were thoroughly investigated, biopsy proved and then subjected for surgery. Immunological assessment was also done. Wide local excision with skin grafting was done. All had positive histopathology for DFSP. Four out of five patients came back for follow-up on a regular basis and have shown no recurrence. One patient was lost on follow-up.

Age is one of the important prognostic factor in determining survival in hollow viscus perforation. We conducted the study to analyze the role of age in determining survival.

Materials and Methods: A prospective survey of patients with acute generalized peritonitis due to hollow viscus perforation was carried out in general surgical wards of our institute during the period starting from January 2014 to September 2015. Study population consisted of 150 consecutive patients with perforativeperitonitis, which confirmed on emergency laparotomy.

Statistical Analysis: Data entry and management was done in Excel sheet. After cleaning and coding the data was transferred to Single master sheet and statistical analysis was done using the SPSS 19 version software.

Results and Conclusion: Age of the patients in the study ranged from 16years to 75years. The mean age of the patients at the time of admission is 42.4 (SD 16.4). Highest mortality is in the age group of > 70 years, (62.5%). There were 8 patients in this age group out of which 5patients died. Lowest mortality (18.75%) is seen in age group of 30-39 years. 4 of 9 patients (MR=44.4%) died in age group of 16-20 years. Mortality rate of 34.48% (10 of 29 patients) seen in age group of 60-69 years. Similarly 26.32% (5 of 19 patients) of mortality rate between 50-59 years, 26.09% (6 of 23 patients) between 40-49 years and 20% (6 of 30 patients) in 21-29 years. Thus in our study mortality rate is more in either extremes of age and with increase in age.

Introduction: Benign Disorders of Breast represent large proportion of workload at specialist breast clinic. It is important to carefully diagnose and distinguish these disorders from premalignant and malignant diseases of the breast. Management requires multidisciplinary approach involving surgeons, pathologists and radiologists. Aims and Objectives: To study incidence, age distribution, various clinical presentations, role and accuracy of fine needle aspiration cytology and management protocol based on the investigations and histopathology of benign breast diseases.

Material and Methods: Present study was a prospective study done over a period of 2 years and includes 100 cases of benign breast lump who attended the outpatient department of General Surgery in a tertiary care hospital, Telangana. Data regarding age, sex, site, laterality and duration of symptoms of the lesion were documented for each case. All the cases underwent routine hematological investigations, mammography, fine needle aspiration cytology and excisional biopsy.

Results: Study included clinically diagnosed 100 cases of benign breast lesions belonging to age group ranging from 11-80 years. Maximum numbers of patients 38 (38%) were in the age group of 21-30 years. According to sex distribution, females were 92 (92%) and males were 8 (8%). Patients presented with different types of symptoms. Sixty eight cases (68%) involved right breast, 28 cases (28%) left breast, and 4 cases (4%) bilateral breasts. Incidence of various lesions based on clinical diagnosis were fibroadenoma 60 (60%), fibroadenosis 12 (12%), gynaecomastia 8 (8%), breast abscess 6 (6%). Four  (4%) cases each of galactocoele and mastitis. Two (2%) cases each of duct papilloma, filariasis, and accessory breast. Fine needle aspiration cytology accuracy was 96%.

Conclusion: Benign breast diseases are common in female patients of 21-30 years of age group; fibroadenoma is the commonest of them all. Fine needle aspiration cytology provides a quick diagnosis and alleviates unnecessary anxiety about breast cancer.
 

Purpose: This retrospective study evaluated the presentations of urolithiasis and effectiveness of ESWL for urolithiasis in pediatric population. 

Materials and Methods: We analyzed the records of 68 children treated with ESWL for urolithiasis in our hospital during the year 2012 to 2017.

Results: Among the 68 children, 49 are males and 19 are females. Common presenting symptoms are abdominal pain or flank pain, nausea or vomiting, microscopic or macroscopic hematuria and fever. Stone clearance rate of 95.6% is noted after the first sitting of ESWL.

Conclusion: ESWL is effective and safe method in pediatric urolithiasis in our hospital.

Burns scars leave a significant impact on patients affecting their physical, social & psychological wellbeing. They are usually complicated by hypertrophy, keloid, contractures & may be associated with pain or itching. Autologous fat is known for its regenerative properties. We present the preliminary results of an ongoing study on application of autologous fat grafting in burn scars conducted between Dec 2015 to Oct 2016 on 8 patients. The preliminary results reveal effectiveness of autologous fat grafting in burn scars.

Background: Duodenitis is an inflammatory condition of the duodenal mucosa. It can be associated with abdominal pain Like peptic ulcer. The present study aim is to evaluate the role of endoscopically confirmed duodenitis not associated with peptic ulcer in the pathogenesis of upper abdominal pain.

Materials and Methods: This study  was conducted in the Department of General Surgery, SUT Medical College, Kerala during the period of Feb 2014-Jan 2015. Total 50 patients were included in the study based on inclusion and exclusion criteria. The patients were explained the procedure and informed consent was obtained. Both sexes were included in the study. All the subjects demographic data was collected; they were evaluated endoscopically for the duodenitis. The data was expressed in number and percentage.

Results: 50 patients were included in the study. 46 were males and 4 were females with age group between 16-60 years. 49 patients had abdominal pain. 26 patients had frequent pain. Maximum patients had moderate pain (23). 15 had Grade-I pain, 23 had Grade-II pain and 8 had GradeIII pain. In the correlation only seven paints showed endoscopic changes with pain.

Conclusion: A significant number of patients showed different grades for abdominal pain in this study. From the study results it can be concluded that duodenitis is a etiological factor for upper abdominal pain not associated with peptic ulcer. There is a requirement of further studies to evaluate the duodenitis with the use of endoscopy for better diagnosis of abdominal pain without peptic ulcer. 

Background: Undescended testis is one of the most common congenital malformations encountered in male neonates and is related to a multifactorial process. The incidence varies and depends on gestational age affecting 1.0-4.6% of full term and 1.1-45% of preterm neonates. Despite spontaneous descent within first months of life, nearly 1% of all full term male infants still have undescended testes at 01 year of age. It may affect both sides up to 30%.In new born cases with non-palpable, undescended testes on both sides and any sign of disorders of sex development, such as con-comitant hypospadias, urgent endocrinologic and genetic evaluation is  required.

Materials and Methods: This study was carried out in the Department of surgery, Great Eastern Medical School & Hospital, Srikakulam, Andhra Pradesh, India. A total of 30 patients were selected for the study from among admitted cases. A thorough clinical assessment, laboratory investigations and radio-imaging studies like Ultrasonography, computerized-tomography and magnetic resonance imaging were performed. Diagnostic laparoscopy was useful to detect nonpalpable and abdominal testis. After confirming
diagnosis, open orchidopexy was performed in 24 cases. Laparoscopic orchidopexy was done in 04 cases and orchidectomy in 02 cases.

Results: Undescended testis was found most commonly among boys of 01-03 years of age group with an
incidence of 55.6% in the present study. Absence of testis in the scrotum was the common complaint in 25 cases (83.4%). 04 cases presented with complications such as inguinal hernia and 1 case with torsion of testis.

Conclusion: The present study concludes that early placement of undescended testis in the scrotal position (orchidopexy) is the gold standard treatment. It also prevents potential impairment of fertility and reduces the risk of testicular malignancy. No consensus exists on the role of hormonal treatment. 

Background: Despite advances in reconstruction techniques, the treatment of sacral sores remains challenging to plastic surgeons. Perforator-based fasciocutaneous flaps for reconstructing pressure sores can achieve good functional results.

Methods: We performed a retrospective review of 12 patients who underwent SGAP flap reconstruction at
SGRDIMSAR over a 1-year period.

Results: There were 8 men and 4 women in the study. All reconstructed flaps survived completely with no mortality or major donor site complications. Three patients had a minor infection and wound dehiscence that healed spontaneously.

Conclusions: These observations suggest that the SGAP flap is a relatively easy flap to raise, with good reliability and minimal complications, and is therefore highly recommended for the reconstruction of the sacral pressure.

Background: Breast cancer is among the top three cancers affecting women across the world and its incidence is increasing worldwide. The size of lump at the time of initial treatment has a direct bearing on the prognosis. Therefore accuracy in detecting the exact size of lump with clinical assessment,imaging modalities like ultrasound and mammography are important tools of management. Neoadjuvant chemotherapy has become an accepted part of breast cancer treatment.Accurate assessment of lump before and after chemotherapy will indicate the response to treatment. The size of lump found in pathological specimen is the gold standard of exact dimension of the lump. Clinical examination, ultrasonography and mammography have all been used to assess the size of the lump and correlate their accuracy in assessing the actual size of lump in pathological specimen after surgery. There are conflicting reports about the accuracy of these tests in various studies conducted so far.

Aim: The aim of the study is to identify the best modality, among Clinical examination, ultrasonography and mammography to assess the size of lump by correlating it to the actual size as found in the pathological specimen after surgery.

Methods: This is a retrospective study of 53 cases of confirmed of breast cancer treated at Adichunchcnagiri hospital and research center BG Nagara over a period of five years from Feb 2011 to Feb 2016. These patients had undergone Physical examintion, ultrsonography and mammography before surgery. Patients who had not undergone both imaging tests in addition to clinical examination were excluded. The data was compiled and correlation of the size of the breast lump was compared with that found after surgical removal of the lump.

Results: Mean age of the study group was 53.5 years. The mean tumour size measured on clinical assessment was 10.77cm, 8.49cm on , mammography and 7.43cm on ultrasonography. Mean histopathological tumour size was 8.66cm.

Conclusion: Mammographic size correlated closest to the size of the lump found in pathological specimen. Clinical examination underestimated and ultrasonography tended to overestimate the size.
 

Background: Traditional treatment of breast disease abscesses involves incision and drainage, with or without ultrasound guidance. This study is  conducted to determine whether needle aspiration of breast abscesses with antibiotis was an effective modality.

Materials and Methods: This prospective study included 70 patients with breast abscesses were treated by needle aspiration of abscess and antibiotics. All were treated out patients basis in Department of Surgery, Gadag Institute of Medical Sciences, Gadag. 

Results: A total of 40 patients (57.14%) out of 70 belonged to age group between 20-40yrs. Study showed 41 patients (58.57%) were lactating and 29 (41.42%)were non lactating. This study also shows 59 (72.85%) patients were treated successfully with aspiration and antibiotics and treatment failure in 19 (27.14%) patients went for surgical drainage.

Conclusion: Antibiotic with needle aspiration is an effective treatment for breast abscesses in rural population.

Introduction: Duodenal injury during laparoscopic cholecystectomy is rare but associated with significant morbidity and mortality.

Methods: This study is a retrospective review of prospectively collected database of patients with postcholecystectomy complications. The study analysed 5 cases of duodenal injury secondary to laparoscopic cholecystectomy and managed by surgical team of our unit.

Results: Mean age of these 5 patients was  54.6 (45-65yrs) out of which 3 were males and 2 females. One case was dealt by immediate intraoperative duodenal repair on recognition of the injury. In other 4 cases, mean interval to re-surgery was 4.8 days. These 4 patients presented with septicaemia with peritonitis. Duodenorapphy with omental patch was done in 3 cases. Tube duodenostomy with feeding jejunostomy was done in one case. 4 out of 5 cases died due persistent sepsis and multiorgan failure. One patient survived with uneventful outcome.

Conclusion: Though rare, duodenal injury secondary to laparoscopic cholecystectomy is potentially a fatal complication. Early diagnosis and prompt management may minimize morbidity and mortality.

Background: The protrusion from abdominal cavity through the inguinal canal is called inguinal hernia. Although inguinal hernia can be direct or indirect and some cases because of posterior wall weakness hernia both Direct and Indirect hernia can be present in the same person. Pantaloon hernia is generally a intraoperatve diagnosis. This study was conducted with the intention of indentifying the incidence of pantaloon hernia in cases of endoscopic hernia repair.

Methods: we retrospectively collected data of patients who underwent laparoscopic hernia repair from January 2015 to December 2017 at our centre, tertiary care Army hospital in Delhi.

Results: There were 81 patients who were operated for endoscopic hernia repair surgery, Total no. of hernias which were operated were 107. Mean age of patients was 50.2 with standard deviation of 12.80. 80.24% patients were male and 19.76% patients were female. Most of our patient had unilateral inguinal hernia (85.0%) among patiens with unilateral hernia Most common form observed was indirect hernia (58%) and only 6.5% were pantaloon hernia. All the hernia repairs were elective procedures and all the surgeries were performed by associate professor and above level, Method of repair included TEPP (96.7%) and TAPP (3.4%).

Conclusion: larger studies are required to know the true incidence of pantaloon hernia and a surgeon should always keep in his mind the possibility of encountering pantaloon hernia while operating a hernia.

Objective: To compare the outcome of stapled hemorrhoidopexy with that of the Milligan-Morgan technique.

Method: Prospective study conducted on186 patients, 93 stapled and 93 open with a follow up period was minimum of 1 month and maximum was 2 years. The two groups were compared for duration of surgery, hospital stay, cost of treatment, return to work and post-operative complications.

Results: The stapled group had statistically significant (P<0.001) lessper operative bleedingshorter duration
of surgery, less post-operative pain and hence need for analgesia. The time taken for the patients to first post-operative defecation, post-operative hospital stayand durationto normal activity was significantly lesser (P<0.001) in the stapled group compared to open group.In the first week of follow up mucoid discharge and pain at defecation was significantly higher in all the 186 patients followed up from the open group. At 6 months, 166 patients,at 1 year, 114 patients, at 1.5 years, 52 patients, at 2 years, 22
patients were available for follow-up. No statistical significance in the complications was found between the 2 groups.

Conclusion: Stapled hemorrhoidopexy is a safer alternative to open hemorrhoidectomy with many short-term benefits. 

 Introduction: Antibiotic use in various surgical procedures should be decided by the surgeon based on the type of case, the duration of surgery, and various patient and environmental related factors. However there has been non judicious usage of antibiotics which has inturn propelled the emergence of antibiotic resistancee and spiralled the treatment cost in hospitals. Hence this study aims to compare  the efficacy of single dose antibiotic usage in our hospital in comparison with conventional antibiotic usage.

Materials and Methods: A randomized control trial was done in fr mullers medical college in the surgical unit. All patients in the study group received single dose antibiotic at the time of induction of anaesthesia. The antibiotic was repeated only if the duration exceeded the half life of the antibiotic . Drains were removed in 24 hrs if found less than 70 ml. The control group patients received one dose of antibiotic at induction of anaesthesia and two doses post operatively. The outcome was assessed in terms of surgical site infection and cost of antibiotics.

Results: In the single dose regimen , 60 cases were clean and infection found in 6.6 % of the patients. 15 patients in group A underwent clean contaminated surgery and were not associated with any infection. The group B patients included 62 patients in the clean surgery category with a infection found in 8.06% of the patients. 18 patients were in the clean contaminated category of group B with no infection reported in this category. The mean duration of surgical time was seen to be higher with 3 dose regimen (67.37 min) as compared to single dose (62.8 min) though the difference was not statistically significant. The overall proportion of infection in our study was higher with group B (6.25%) as compared to single dose (5.33%). The cost of antibiotic in the group A patients was lesser than group b patients.

Conclusion: we found no statistically significant difference in the surgical site infection rate between the single or the three dose group of patients.

Introduction: Phimosis is defined as a condition in which the prepuce cannot be retracted over the glans penis, usually treated by circumcision. A minimal surgical techniques have been proposed preputioplasty for prepucial relief to avoid circumcision.

AIMS/Objectives: Prospective Comparative Study Of Management Of Phimosis By Techniques Of Circumcision And Preputioplasty in relation to: Bleeding, Injury to urethral meatus. Injury to glans, Post op swelling of glans / prepuce, Time taken for the procedure,Time taken for complete healing, Post operative results.

Methods: It is a prospective comparative study in which 100 patients who underwent preputioplasty and 100 were subjected to circumcision. Indications, techniques, and immediate outcomes were documented. We have subsequently followed up patients to look for outcome and patient’s satisfaction.

Result: The average duration of preputioplasty was from 10 to 20 min without intraoperative complications. Post operative edema was more with preputioplasty. The outcome was good in preputioplasty as compared to
circumcision. All of the patients had retractable prepuce with no functional problems. None of the patients required a redo procedure or circumcision.

Conclusion: Preputioplasty is a safe and simple alternative to more radical procedure of circumcision.

Introduction: Necrotizing fasciitis represents a group of highly lethal infections characterized by rapidly progressing inflammation & necrosis. Early recognition & aggressive surgical treatment in combination with antibiotic therapy can prevent fatal consequences.

Aims and Objectives: The aim of the study was to assess the clinical profile, analyse the microbial flora & the outcome of aggressive surgical management in combination with intravenous Penicillin therapy.

Material and Methods: A prospective  study was carried out in our hospital between April 2016 to December 2017. Predisposing factors, clinical presentations, microbial flora and management amongst thirty consecutive patients who had presented to this hospital during this period were studied.

Results: Age above 45 years, trauma & diabetes mellitus were the commonest predisposing factors. All wounds had polymicrobial growth. Repeated aggressive debridement was carried out in most patients with average of 3.5 debridements per patient. Majority of the wounds healed by secondary intention. However, 30% of the patients needed skin grafting.

Conclusion: Early & aggressive surgical debridement, often in multiple sittings, supplemented by appropriate antibiotics & supportive therapy forms the key to successful outcome. Low threshold & early
referral by family physicians can prevent the potent complications of necrotizing fasciitis.

Background: Early operative debridement is a major determinant of outcome in necrotizing fasciitis which could often prove clinically difficult. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was devised as a scoring system for necrotising fasciitis. Our study was done for the validation of the same.

Methods: The study was a prospective observational and descriptive study in a tertiary care teaching hospital. This was mainly done to assess the LRINEC scoring system and validate the system Patients presenting with soft tissue infections admitted over a period of two years were clinically examined and subjected to a proforma of the LRINEC scoring system. The same was assessed statistically to interpret the outcomes with regards to the scoring.

Results: A total of 152 patients with suspected necrotising fasciitis were taken for the study out of which 96 patients underwent surgical debridement. On calculating the strength of association of individual variable with the scoring system LRINEC - Age/Hb/TLC/RBS/S. Creatinine/CRP has been found to be independently significant variables. Receiver operating characteristic (ROC) curves showed a positive predictive value of 94.7%.

Conclusions: LRINEC scoring system is helpful in stratifying patients into risk categories, thus appears capable of detecting early cases of necrotizing fasciitis and is simple enough for routine use.

Background and Objectives: Thyroid disorders are frequently encountered at the surgical outpatient department. Harmonic scalpel uses high-frequency mechanical energy to cut and coagulate tissues and vessels simultaneously. In this study, we evaluated the efficiency, safety, and the impact on the surgical outcome of the utilization of harmonic scalpel during total thyroidectomy.

Methods: Out of 60 patients included in the study, 30 underwent total thyroidectomy using conventional methods including monopolar/ bipolar cautery and 30 using harmonic scalpel. Post-operative transient hypocalcemia, recurrent laryngeal nerve palsy, drain output and total duration of surgery were compared among the groups.

Results: Both the groups had comparable age and sex ratios. The duration of surgery was significantly      (p < 0.05) shorter in the harmonic scalpel (97.5±13.75 min) than in the conventional technique group (131.5±21.21 min). Post-operative drain outputat 24 and 48 hours in harmonic scalpel group (23±8.8 ml, 34±8.0 ml) was significantly lower than conventional group (30±5.8ml, 46.33±9.18 ml)(p <0.05). The incidence of transient hypocalcemia was significantly more (p<0.05) in conventional (n= 6) group as compared to harmonic group (n=1). Hoarseness of voice associated with recurrent laryngeal nerve injury was observed in three patients in conventional group. Hoarseness of voice was not observed in patients of harmonic scalpel group.

Conclusion: Use of harmonic scalpel in thyroidectomy is safe and effective and lowers incidence of postoperative complications, shorter operative time, and lower drain output.

Thyroidectomy; Harmonic Scalpel; Electro Cautery.

Inguinal hernia repair is the most frequently performed operation in any general surgical unit [3]. Hernioplasty is most commonly performed surgery for hernia. Mesh fixation is a major step in hernioplasty regularly mesh is fixed with nonabsorbable prolene sutures as there is longer operative time, more pain during post-operative period and foreign body sensation, sutures are replaced by nbutyl-2-cyanoacrylateglue mesh fixation in Lichtenstein hernia repair. To study the outcome of n-butyl-2-cyanoacrylateglue versus sutured mesh fixation in Lichtenstein hernia repair with respect to postoperative pain.

Materials and Method: 50 cases in each group is considered who are presenting to surgical opd in B.L.D.E.U’s Shri B.M. Patil Medical College Hospital in the period of June 2014 to May 2015.

Results: The number of patients with chronic pain who underwent hernioplasty with glue fixation is less (10%) when compared to number of patients with chronic pain who underwent Lichtenstin’s hernioplasty with sutures (26%). This association is found to be statistically significant in our study as compared to other studies in which there was no significant change in pain with glue and suture fixation of mesh. Use of N butyl cyanoacrylate glue for Lichtenstein hernia repair is more efficacious than regularprolene suture mesh fixation and also has the potential to reduce the incidence of chronic inguinodynia and foreign body sensation. There is less chronic pain after 12months in n butyl cyanoacrylate group mesh fixation.