Mesh Fixation with Autologous Platelet-Rich Fibrin Sealant in Inguinal Hernia Repair

Background: Chronic pain is the main complication following inguinal hernia repair. A possible explanatory factor is the suture fixation of the mesh. Glue fixation might overcome this problem. Albeit at a very low frequency, human and bovine components of fibrin sealants currently available could contain blood-borne pathogens. Autologous platelet-rich fibrin sealant (P-RFS) eliminates this risk and has additional advantages such as hemostatic and antibacterial effects. Therefore, its feasibility was assessed in inguinal hernia repair, with a focus on pain. Methods: In 22 patients with primary inguinal hernia, the mesh was fixated with P-RFS. Data included operative variables, complications, pain scores and neurological examinations. Long-term follow-up was 22.2 months (SD 2.2) postoperatively. Results: After 2 weeks, visual analogue scale and disability pain scores were lower than they were preoperatively. Complications at 3 months were 1 recurrence, 1 chronic pain and 6 sensory disturbances. At the last clinical evaluation, the recurrence was planned for repair due to discomfort. No chronic pain, sensory disorders or discomfort was reported at long-term follow-up. Conclusion: Mesh fixation with autologous P-RFS is feasible. If there is a preference for autologous material, P-RFS is indicated. If glue fixation becomes standard, further randomized studies are warranted for this alternative. Copyright (C) 2009 S. Karger AG, Basel