Manzoor Ahmed, Mukhtar Mehboob.
Comparisons of Onlay versus Sublay Mesh Fixation Technique in Ventral Abdominal Wall Incisional Hernia Repair.
J Coll Physicians Surg Pak Jan ;29(9):819-22.

Objective: To compare the results of onlay with sublay mesh repair technique for ventral incisional hernia. Study Design: Comparative study. Place and Duration of Study: Surgical Unit IV, Sandeman (Provincial) Hospital, Quetta and Mohtarma Shaheed Benazir Bhutto Hospital, Quetta, from July 2016 to December 2017. Methodology: Sixty-five patients, diagnosed by clinical examination as ventral incisional hernia, were included in the study. Patients were divided randomly into two groups. Group 1 had onlay mesh repair while group 2 were subjected to Sublay mesh fixation technique. Results of the procedures done in terms of operative time, wound infection, seroma formation, hospital stay, and follow-up. The data was analysed by the SPSS. Results: The age ranges from 18-65 years, mean 39.13 +11.76 years. There were 42 males (64.61%) and 23 females (35.4%). The distribution of ventral incisional hernia was 42 (64.61%) in midline, followed by subcostal incision in 10 (15.38%) patients. In group 1, a total of 33 (50.76%) patients underwent onlay mesh repair, while 32 (49.23%) patients had underwent sublay mesh repair in group 2 (p=0.007). The wound infection and dehiscence was less in group 2. The seroma formation was prevalent in group1 (p-value 0.005). The hospital stay in group 2 was less (p=0.003).The follow up for 6 months revealed no recurrence in 20 patients of group 1 and 12 patients of group 2. Conclusion: Group 2 has a definitive edge over group 1 in the management of incisional hernia. The morbidity of the patient in group 2 was lower than group 1.

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