Comparison of Onlay vs Sublay Mesh Repair of Anterior Abdominal Wall Hernias; A Randomize Control Trial
DOI:
https://doi.org/10.52206/jsmc.2025.15.1.941Abstract
Background: Various surgical technique has been developed for anterior abdominal wall mesh placement, including onlay, inlay, sublay, preperitoneal, and intraperitoneal positions. Many advantages and disadvantages are linked to these surgical procedures.
Objectives: To compare onlay and sublay mesh repair techniques for anterior abdominal wall hernias in relation to the mean operative time, post-operative wound infections and seroma formation.
Materials and Method: The study was a randomized control trials, conducted at BKMC Swabi. The study includes 78 patients that were randomly allocated into two groups i.e. 39 patients in Group A (Onlay technique) and 39 in group B (Sublay Technique). Written informed consent was obtained from all participants. Upon enrollment, demographic information was recorded, and detail clinical examinations were conducted.
Results: Group A had a mean age of 43.05 years (SD = 5.385), a mean BMI of 26.46 (SD = 1.144), and an average operation time of 142.18 minutes (SD = 14.017) (p=0.037). In contrast, Group B had a mean age of 42.85 years (SD = 5.284), a mean BMI of 26.18 (SD = 0.885), and a significantly shorter average operation time of 105.77 minutes (SD = 1.307). Age distribution was similar between groups, with around 80% over 40 years old. Gender distribution was slightly more male in Group B (53.8%) compared to Group A (48.7%). ASA class distribution was identical across both groups. Postoperative wound infection rates were higher in Group B (35.9%) compared to Group A (23.1%) (P=0.214). Seroma formation was more common in Group A (46.2%) compared to Group B (35.9%) (P= 0.357).
Conclusion: Sublay repair better in terms of reduced operative time, decreased seroma formation compared to Onlay repair but higher incidence of postoperative wound infections in sublay's procedure should kept under the consideration and proper pre, per-op and post-op wound infections protocols should be followed.
Keywords: Mesh repair, Mean Operative-time, Onlay Technique, Post-operative wound infections, Sublay Technique and Seroma formation.
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