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Evaluation of Sublay Mesh Repair in Comparison with Onlay Mesh Repair for Incisional Hernias

Author: Haider Abdulhussein Ahmed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 180-184
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية


ABSTRACT:BACKGROUND: Incisional hernia after abdominal surgery is a well-known complication and the incidence of incisional hernias continues to be 2-11% 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. The sublay technique, popularized by Rives and Stoppa in Europe, has been reported to be quite effective, with low recurrence rates and minimal complications.OBJECTIVE: To study the advantage and complications of sublay mesh repair of incisional hernias in comparison to onlay mesh repair.METHODS: Record of 110 patients undergoing repair of incisional hernia from 1st Jun 2013 to 1st Jun 2015, excluding very large incisional hernia with defect more than 10 cm. 62 cases of incisional hernias were managed by onlay mesh repair and 48 cases of incisional hernia were managed by sublay mesh repair.RESULTS: Post-operative complications like seroma and wound infection were comparable in both groups. In sublay group, Seroma formation was 2 patients (4.3%) . wound infection was 2 patients (4.3%). No septic mesh was removed in the series. In onlay group seroma formation was in 12 patients (19.4%) most of seroma occur in large incisional hernias repair, wound infection was in 5 patients (8.1%) and 2 septic mesh was removed. In sublay, recurrence rate was one patient (2.1%), in onlay, recurrence rate was in 5 patients (8%). CONCLUSION: Sublay mesh although it is more time consuming and technically more difficult, however it carries low recurrence rate and few post-operative wound complication ..

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