COMPARISON OF ONLAY VERSUS SUBLAY MESH REPAIR FOR VENTRAL ABDOMINAL HERNIAS. A RANDOMIZED CONTROLLED TRIAL
To compare onlay versus sublay mesh repair for ventral abdominal hernias in terms of mean operative team, frequency of post-operative wound infection, seroma formation and hematoma formation.
Study Design: Randomized controlled trial.
Place and Duration of Study: Department of General Surgery, Pak Emirates Military Hospital Rawalpindi, from Apr 2017 to Dec 2017.
Material and Methods:
A total of 78 patients (39 in each group) diagnosed as a case of ventral abdominal hernia meeting the inclusion and exclusion criteria were included in the study. Patients with complicated hernias, recurrent hernias and bleeding disorders were excluded. Group-A patients underwent mesh repair by the onlay method while group-B patients underwent mesh hernioplasty via the sublay technique. All patients were followed for wound infection, seroma formation and hematoma formation. Data was analyzed by SPSS ver. 23.0.
The mean operation time in group A was 46.10 ± 7.25 minutes while in group B, the mean operation time was 77.82 ± 9.97 minutes (p<0.001). The frequency of wound infection was 5.13% vs 0% (p=0.49) and hematoma formation was 5.13% vs 7.69% (p=0.999) between the two groups respectively which were statistically insignificant. However, seroma formation between the two groups was 23.08% vs 5.13%, which was statistically significant (p=0.023).
Sublay mesh repair for ventral hernias is better than onlay mesh repair for ventral abdominal wall hernias in terms of frequency of complications. However, it requires a longer operative time.