Incidence of seroma in sublay versus onlay mesh repair of incisional hernia

Neto

ABCD, arq. bras. cir. dig.

et al. 2022

BACKGROUND: The development of an incisional hernia is a common complication following laparotomy. It also has an important economic impact on healthcare systems and social security budget. The mesh reinforcement of the abdominal wall was an important advancement to increase the success of the repairs and reduce its long-term recurrence. The two most common locations for mesh placement in ventral hernia repairs include the premuscular (onlay technique) and retromuscular planes (sublay technique). However, until now, there is no consensus in the literature about the ideal location of the mesh. AIM: The aim of this study was to compare the two most common incisional hernia repair techniques (onlay and sublay) with regard to the complication rate within the first 30 days of postoperative care. METHOD: This study analyzes 115 patients who underwent either onlay or sublay incisional hernia repairs and evaluates the 30-day postoperative surgical site occurrences and hernia recurrence for each technique. RESULTS: We found no difference in the results between the groups, except in seroma formation, which was higher in patients submitted to the sublay technique, probably due to the lower rate of drain placement in this group. CONCLUSION: Both techniques of mesh placement seem to be adequate in the repair of incisional hernias, with no major difference in surgical site occurrences.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Onlay Versus Sublay Techniques for Incisional Hernia Repair: 30-Day Postoperative Outcomes

Neto

ABCD, arq. bras. cir. dig.

et al. 2022

Journal of Surgical Case Reports

“…Seroma is a common complication after mesh repair. 30–50% of open mesh repairs result in seroma [ 9 ]. Most seromas develop above the mesh.…”

Section: Discussionmentioning

confidence: 99%

“…Seroma formation is a common complication after IH repair, especially with mesh. Its frequency ranges from 30 to 50% after open mesh repair [ 9 ]. This article talks about our first experience fixing a Pfannenstiel IH (PIH) with an inlay mesh technique and a seroma that formed after the surgery.…”

Section: Introductionmentioning

confidence: 99%

Our first Pfannenstiel incisional hernia. A case report

Cervantes

Acevedo

Lopez

et al. 2022

The incidence of the Pfannenstiel incisional hernia (IH) is the lowest of all IHs, it can occur due to patient-related factors or faulty technique in closure of the deeper layer. The use of prosthetic mesh repair is heralding a new era of tension-free herniorrhaphy, while the optimal location for its implantation remains controversial. As a result, no strategy or technique has become the gold standard for its repair. We report our first experience with an IH through Pfannenstiel in a 49-year-old obese female patient. Inlay polypropylene open mesh repair was performed. As the only complication, the patient presented with a seroma in the wound, which was aspirated, and she is currently asymptomatic with outpatient consultation follow-up. Pfannenstiel IHs have received minimal attention on the optimal surgical approach and postoperative results, making this case a good starting point for future studies.

Haydarpasa Numune Med J

“…In addition, no significant differences were reported in terms of recurrence and infection rate in the systematic reviews of the publications about the "sublay" and "onlay" graft technique [10,11] . On the other hand, it is thought that "sublay" grafts cause less seroma formation [12] . Despite the high complication rate of "onlay" graft repair, it is also reported that it causes less recurrence [13] .…”

mentioning

confidence: 99%

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

Okuyan¹

2021

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.