Investigators from England compared collagen mesh with polypropylene mesh in primary inguinal hernia repair.
Tissue repair of primary inguinal hernia using mesh relies on scar tissue bonding the mesh to give a sound repair.
Collagen has the theoretical advantage of using natural collagen, which will be incorporated into the repair, and will not be a permanent foreign body.
A total of 140 patients were prospectively randomized to receive either polypropylene (n = 62) or collagen mesh (n = 78).
Performance was compared at operation and at 3 months and 12 months postoperatively.
The patient's perceptions and quality of life were both measured.
There was no difference in handling, insertion, and suturing at operation between the groups.
The team found that, postoperatively, there was an increase in hematoma in the polypropylene group.
However, infection and inflammation were similar postoperatively and at 3 months in both groups.
| Fewer postoperative hematomas with collagen mesh.
| British Journal of Surgery |
There was one recurrent hernia in each group at 1 year.
Postoperative activity and pain scores were also similar, and were normal by 4 weeks.
It was found that quality of life was significantly reduced in both groups at 4 weeks.
Of particular note was that, at 3 months, there was reduced physical function in the polypropylene group.
The authors, from Scunthorpe General Hospital and the University of Sheffield, England, said that the initial results showed that collagen mesh is an effective method of providing tissue repair in primary inguinal hernia.
The collagen mesh produced fewer hematomas postoperatively and patients recovered physical activity more quickly, they added.
Otherwise, it produced results comparable to polypropylene, without the risks of a permanently implanted foreign body, they concluded.
The team proposes to recruit 200 patients to the study and undertake follow-up for 2 years postoperatively.