Comparison of "onlay" and "sublay" methods of mesh repair of incisional hernia in terms of early and late period wound complications

Abstract

Introduction: Different approaches are used depending on placement of mesh in the surgical treatment of incisional hernia. These methods have controversial results in terms of wound complications and recurrence. In this study, it was aimed to compare open mesh repair of incisional hernia using the approaches of "onlay" and "sublay" mesh placement in terms of complications and recurrence. Methods: Patients who underwent mesh repair of incisional hernia in our hospital for a 2-year retrospective study were evaluated. The patients were divided into two groups according to the placement of the polypropylene mesh: "onlay" (Group O, n=27) and "sublay" (Group S, n=25). Demographic and clinical data of the patients were recorded. Postoperative early (seroma, hematoma, wound infection) and late (chronic pain, recurrence) complications were compared between groups. Results: There were 52 patients in the study with a mean age of 60.4±12 years. There was no difference between the groups in terms of demographic and clinical characteristics (p>0.05). The mean duration of the surgery in Group S was significantly longer than Group O (p=0.02). Although the length of hospital stay was longer in Group S, there was no significant difference between the two groups in terms of the length of hospital stay (p=0.067). There was no significant difference between the groups in terms of early and late wound complications (p>0.05). Discussion and Conclusion: There is no significant difference between early and late wound complications after mesh repair of incisional hernia with "onlay" and "sublay" methods. Both methods can be applied with similar efficacy and safety.