Muhammad Idrees Anwar, Tariq Nawaz, Muhammad Younus, Imran Khalid, Asif Zafar Malik.
Mesh Repair for Incisional Hernia.
J Surg Jan ;19-20:30-2.

Large incisional hernia is a challenging for the surgeons and usually met with high recurrence rate. Mesh repair has reduced the recurrence rate but with the cost of higher morbidity. This study was done at two teaching hospitals associated with Rawalpindi Medical College where 75 patients were operated for and subcutaneous mesh was placed over the repaired rectus sheath. Very few patients developed superficial wound infection (5%) and none of the mesh required removal. The only other complication encountered was feeling of tightness under the skin (19 %). One year follow up showed no recurrence. Conclusion: Infection is commonest cause of development of incisinal hernias. Mayos repair is a weak repair and lead to higher recurrence. Selected patients may require adhenolysis and or apronectomy. Large incisional hernias can only be managed by use of synthetic mesh. Primary repair of defect is possible, without tension with majority of hernias. Proper aseptic technique and thorough debridement would reduce infection in mesh. Subcutaneous mesh is better technique and has less incidence of ileus post operatively. The feeling of tight sensation is only temporary and small price to pay for good cosmosis.

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