Hernia repair and management
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The Turkish version of the CCS is a valid and reliable instrument for assessing long-term outcomes after mesh-based inguinal hernia repair and can be used in both clinical practice and research.
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While generic instruments like the short form-36 (SF-36) and the visual analog scale (VAS) are staples in assessing quality of life and pain following hernia repair, they often struggle to capture the full clinical picture (6).The SF-36, being a broad health measure, frequently lacks the sensitivity required to pinpoint hernia-specific or meshrelated issues.Similarly, the VAS is restricted to pain intensity alone, overlooking critical factors such as foreign body sensation and mobility restrictions that are common after mesh-based procedures (7).To address these gaps, the Carolinas comfort scale (CCS) was developed specifically to evaluate pain, movement limitation, and the sensation of the mesh itself (8).The CCS has been extensively evaluated in the literature, validated across multiple clinical settings, and shown to be a sensitive instrument for assessing postoperative outcomes after mesh repair (8-11).To date, the CCS has been translated into 25 languages and is currently used in 48 countries worldwide (4).However, a validated Turkish version of the scale is not yet ABSTRACT Objective: Mesh-based inguinal hernia repair has reduced recurrence rates; however, long-term postoperative symptoms remain clinically relevant.The Carolinas comfort scale (CCS) is a disease-specific tool developed to assess these outcomes.This study aimed to validate the Turkish version of the CCS and evaluate long-term quality of life. Material and Methods:The CCS was translated and culturally adapted using standardized procedures.A retrospective cohort of patients who underwent elective inguinal hernia repair with mesh between 2018 and 2020 was analyzed.Reliability, validity, and factor structure were evaluated using established statistical methods.Results: A total of 85 patients were included, with a median follow-up of 79 months.The Turkish CCS demonstrated excellent internal consistency (Cronbach's α=0.952), strong convergent validity with VAS (ρ=0.952,p<0.001), and significant discriminative validity for chronic pain (p<0.001).The recurrence and chronic pain rates were 10.6% and 35.3%, respectively. Conclusion:The Turkish version of the CCS is a valid and reliable instrument for assessing long-term outcomes after mesh-based inguinal hernia repair and can be used in both clinical practice and research.
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@article{Bulut2026Turkish,
title = {Turkish version of the Carolinas comfort scale: Validation and long-term clinical outcomes after mesh-based inguinal hernia repair},
author = {Alisina Bulut and Doğuş Can Ekdal and Ömer Faruk Acar and Betül Ekşim and Israa Maryem El Qadiri and Mehtap Semiz and Nurbanu Mankan and Ömer Günal},
journal = {Turkish Journal of Surgery},
year = {2026},
doi = {10.47717/turkjsurg.2026.2026-5-24},
url = {https://doi.org/10.47717/turkjsurg.2026.2026-5-24}
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