Comparisons of onlay versus sublay mesh fixation technique in ventral abdominal wall incisional hernia repair

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. (author)