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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

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Abstract

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 ..


Article
Open Onlay Mesh Repair for Abdominal Incisional Hernia
تصنيع الفتق الجراحي بأستعمال الشبكة

Authors: Adil Karim Alhamdani د.عادل كريم الحمداني --- Jasim Abed Albedr د. جاسم عبد البدري --- Hadeel J. Abd د.هديل جاسم البدري
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2012 Volume: 25 Issue: 4 Pages: 347-351
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract Background: The incisional hernias still continue to be a serious problem and challenge for surgeons.Objective: To see the relative effectiveness of open Onlay mesh repair for incisional hernia in terms of clinical outcome, quality of life and rate of recurrence.Patients and methods: The study conducted at Al- Yermouk Teaching Hospital, Baghdad. Between April2006 - July 2009 out of fifty four patients operated upon for incisional hernia by open Onlay mesh graft type of repair. There were 19females and 35 males, with a mean age of 50. The clinical, surgical, and follow-up data were analyzed.Results: Mean operating time was 130 min, with an average hospital stay of 8 days. There was no mortality. Postoperative complications occurred in 33.25% of the patients. Most common complications were surgical site infection (SSI) 11.11%, recurrence of 9.25% and seroma 7.4%, respiratory complications 5.5%, DVT 1.85% were found after follow-up of 12- 18 months.Conclusion: The incisional hernia recurrence, morbidity & complications are significantly low in onlay mesh repair.Key words: Incisional hernia, open onlay repair, complications.

الخلفية:- عملية تصنيع الفتق الجراحي تشكل تحدي للجراحين. الغرض:- دراسة التأثيرات النسبية بأستعمال الشبكة لتصنيع الفتق الجراحي من الناحية السريرية, نوع حياة المريض ونسبة رجوع المرض.المرضى والطرق:- أجريت دراسة أستباقية في مستشفى اليرموك/ بغداد لاكثر من ثلاث سنوات من نيسان 2006 م-تموز 2009 م على 54 مريض, 35 رجال 19 أناث. متوسط العمر 50 سنة مع متابعة المريض 12-18 شهر بعد العملية. النتائج:- معدل وقت العملية 130 دقيقة ,معدل رقود المريض 8 أيام, لم تحدث حالة وفاة, هناك 33.25%مضاعفات منها 11.11%التهاب الجرح, 9.25% رجوع الفتق, 7.4% تجمع سوائل تحت الجرح, .55% التهاب المجاري التنفسية, 1.85% تخثر الاوردة العميقة. الأستنتاج:- رجوع الفتق ومعاناة المريض قليلة نسبيأ بأستعمال الشبكة لتصنيع الفتق الجراحي. مفتاح الكلمات:-الفتق الجراحي , تصنيع الفتق ,المضاعفات.

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