Influence of a Relaxing Incision on Suture Tension in Bassini's and McVay's Repairs

• Suture tension levels measured during 151 inguinal herniorrhaphies in 135 men were higher initially and after a standard relaxing incision in 78 McVay's as compared with 73 Bassini's repairs. The difference, as well as the effect of the relaxing incision on tension, was greater in the middle. In 77 indirect repairs, before relaxation suture tension differed in 51 Bassini's and 26 McVay's procedures only in the midzone. However, with a relaxing incision, the former had much less tension. Similar results were obtained in 74 direct hernias, but better relaxation was seen in 52 McVay's repairs than with their indirect counterparts. These findings were confirmed when 42 McVay's and 37 Bassini's operations on equally (moderate) sized defects were compared. Thus, the complete repair (McVay's operation), with closure of the femoral canal and a deeper, more posterior suturing than in Bassini's operation, is associated with more tension. Use of a relaxing incision is obviously indicated. Further follow-up of our cases may substantiate that the level of suture tension at the time of operation correlates with the risk of recurrence.

(Arch Surg 1981;116:440-445)