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Abstract

 BACKGROUND:Incisional hernia after abdominal surgery is a well-known complication and the incidence of incisionalhernias continues to be 2-11% after laparotomy. The repair of incisional hernia has always been achallenge to the surgeon. Various operative techniques for the repair of incisional hernia are in practice;however, the management is not standardized. The sublay technique, popularized by Rives and Stoppain Europe, has been reported to be quite effective, with low recurrence rates and minimalcomplications.OBJECTIVE:To study the advantage and complications of sublay mesh repair of incisional hernias in comparison toonlay mesh repair.METHODS:Record of 110 patients undergoing repair of incisional hernia from 1st Jun 2013 to 1st Jun 2015,excluding very large incisional hernia with defect more than 10 cm. 62 cases of incisional hernias weremanaged by onlay mesh repair and 48 cases of incisional hernia were managed by sublay mesh repair.RESULTS:Post-operative complications like seroma and wound infection were comparable in both groups. Insublay group, Seroma formation was 2 patients (4.3%) . wound infection was 2 patients (4.3%). Noseptic mesh was removed in the series. In onlay group seroma formation was in 12 patients (19.4%)most of seroma occur in large incisional hernias repair, wound infection was in 5 patients (8.1%) and 2septic mesh was removed. In sublay, recurrence rate was one patient (2.1%), in onlay, recurrence ratewas in 5 patients (8%).CONCLUSION:Sublay mesh although it is more time consuming and technically more difficult, however it carries lowrecurrence rate and few post-operative wound complication .

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