COMPARATIVE STUDY ONLAY VS PREPERITONEAL MESHPLASTY FOR REPAIR OF INCISIONAL HERNIA

Dr Vineet Prajapati, Dr. Asif Meman, Dr. Harish chauhan

Abstract


INTRODUCATION: Incisional hernia have been reported in 2-11% of patients undergoing laparotomy. Incisional hernia is due to biologic problem of stable scar tissue formation. In this prospective study  we compared the results of the preperitoneal verses onlay meshplasty in influencing the final outcome in incisional hernia management with regards to duration of surgery, techniqal difficulties, hospital stay, post opertative analgesia requirenment, wound complication and return to normal activity.

MATERIAL AND METHDS. In present series 100 cases of Incisional Hernia studied in department of surgery in SMIMER Medical College Surat. In this Group consisted of 28 Male and 72 Female patients. 50 Patients had onlay meshplasty and 50  had preperitoneal meshplasty by open techniqus. All patients were preoperatively evaluated by thorough clinical examination and ultrasound.

RESULT: 8 out of 50 cases of preperitoneal meshplasty had seroma formation which resolved spontaneously. 12 out of 50 cases of onlay technique had seroma formation out of which 6 resolved spoteneously and  6 required needle aspiration. Major wound infection was noted in 8 patients undergoing onlay meshplasty.

CONCLUSION: Whereas preperitoneal meshplasty is ideal  decrese the severity of wound infection without significant problems like bowel injury. Onlay meshplasty is more chance of mesh involvement in postoperative infection which leads to prolonged hospital stay ,more antibiotics need. 


Keywords


Incisional Hernia, preperitoneal(sublay), onlay,meshplasty.

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