Trends in Clinical and Medical Sciences
Special issue: Recent developments of medical and surgical research (2023), pp. 348 – 358
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr048
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr048
A comparative study of onlay versus sublay mesh repair in cases of ventral hernia in adults
Rajesh kumar Dora\(^{1}\), Vishwajeet Sahanee\(^{2}\), Debashisha Roy\(^{3}\), Amar Kumar Behera\(^{4,*}\) and Bharat Kumar Behera\(^{5}\)
\(^{1}\) Department of Surgery, Government Medical College and Hospital Keonjhar.
\(^{2}\) Department of Surgery, M.K.C.G Medical college, Berhampur.
\(^{3}\) Department of Surgery, SCB Medical College and Hospital, Cuttack, Odisha.
\(^{4}\) Department of Surgery, Government Medical College and Hospital, Sundargarh, Odisha, India.
\(^5\) Professor, Department of Surgery, Government Medical College & Hospital Sundargarh, Odisha, India.
Correspondence should be addressed to Amar Kumar Behera at amar_behera@yahoo.co.in
Copyright © 2023 Rajesh kumar Dora, Vishwajeet Sahanee, Debashisha Roy, Amar Kumar Behera and Bharat Kumar Behera. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: December 11, 2022 – Accepted: April 23, 2023 – Published: April 29, 2023
Abstract
Background: Ventral hernias of the abdomen are defined as a non-inguinal, non-hiatal defect in the fascia of the abdominal wall. Annually, there are about 350,000 ventral hernia operations. The repair of these abdominal wall defects is a common surgery performed by general surgeons. Common causes of acquired ventral hernias include previous surgery causing an incisional hernia, trauma, and repetitive stress on naturally weak points of the abdominal wall. These naturally occurring weak points in the abdominal wall include the umbilicus, semilunar line, ostomy sites. Obesity is a large component of hernias as well because it stretches the fascia of the abdomen causing it to weaken. While repair of ventral hernias with mesh is considered routine, there is no consensus on the best location to place the mesh. Hence, this study aims to compare the outcome of the onlay versus sublay mesh repair for treatment of ventral hernias.
Materials and methods: All subjects undergoing onlay and sublay mesh repair for ventral hernias will be evaluated intraoperatively for duration of surgery and postoperatively for complications like surgical site infections, seroma formation, flap necrosis, duration of hospital stay and recurrence. To find the significance in categorical data Chi-Square test was used.
Aim of the study and objectives: To compare the duration of surgery and postoperative complications of sublay and onlay meshplasty in the treatment of ventral hernias.
Results: Out of 50 patient’s majority were female29 (58%) and belong to the age group of 46-55 yrs (32%). The most common diagnosis among them is supraumbilical hernia (52%). The duration of surgery for sublay group is longer about 117.4 min whereas it about 92.52 min in onlay group. Seroma formation, Surgical site infection, Flap Necrosis in 20%, 16% and 16% patients respectively in onlay mesh repair group and in 4%, 4% and nil patients respectively in sublay mesh repair group. Duration of Hospital Stay was 5 days in onlay group in comparison to 4 days in sublay group. Recurrence was seen in 8% patients in onlay group whereas it was encountered 4% in the sublay mesh repair group.
Conclusion: Sublay mesh repair is a good alternative to onlay mesh repair that may be applicable to all forms of ventral hernia as the mesh related overall complication rate like seroma, surgical site infections, flap necrosis, hospital stay and recurrence are less compared to onlay meshplasty.
Materials and methods: All subjects undergoing onlay and sublay mesh repair for ventral hernias will be evaluated intraoperatively for duration of surgery and postoperatively for complications like surgical site infections, seroma formation, flap necrosis, duration of hospital stay and recurrence. To find the significance in categorical data Chi-Square test was used.
Aim of the study and objectives: To compare the duration of surgery and postoperative complications of sublay and onlay meshplasty in the treatment of ventral hernias.
Results: Out of 50 patient’s majority were female29 (58%) and belong to the age group of 46-55 yrs (32%). The most common diagnosis among them is supraumbilical hernia (52%). The duration of surgery for sublay group is longer about 117.4 min whereas it about 92.52 min in onlay group. Seroma formation, Surgical site infection, Flap Necrosis in 20%, 16% and 16% patients respectively in onlay mesh repair group and in 4%, 4% and nil patients respectively in sublay mesh repair group. Duration of Hospital Stay was 5 days in onlay group in comparison to 4 days in sublay group. Recurrence was seen in 8% patients in onlay group whereas it was encountered 4% in the sublay mesh repair group.
Conclusion: Sublay mesh repair is a good alternative to onlay mesh repair that may be applicable to all forms of ventral hernia as the mesh related overall complication rate like seroma, surgical site infections, flap necrosis, hospital stay and recurrence are less compared to onlay meshplasty.
Keywords:
Sublay mesh repair; Onlay mesh repair; Surgical site infections; Ventral hernias.