A COMPARATIVE STUDY BETWEEN ONLAY AND SUBLAY MESH REPAIR IN THE MANAGEMENT OF INCISIONAL HERNIA

Abstract

Background: An incisional hernia is one of the common complications of abdominal surgery and the incidence of incisional hernias continues to be 3 to 11% after laparotomy. The repair of incisional hernia has always been a challenge to the surgeon. Various operative techniques for the repair of incisional hernia are in practice; however, the management is not standardized. Aim: To compare onlay mesh placement versus sublay mesh placement in repair of incisional hernias. This prospective study Material and Methods: comprised of 50 patients with an incisional hernia. A total of 50 cases were included in the study. Of the 50 cases, 25 cases were operated by the onlay mesh method and 25 by sublay mesh placement. Results: The operative time for sublay mesh repair was signicantly higher than that of onlay mesh repair, whereas, complications like haemorrhage, seroma formation and deep surgical site infection leading to extrusion of mesh was higher in onlay mesh repair. The recurrence rate was found to be 4% in onlay mesh repair whereas it was 0% in sublay mesh repair. Sublay mesh repair, though technically difcult, Conclusion: and takes more time for surgery has the distinct advantage of reducing the rate of infection and recurrence.