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Article Type

Original Study

Abstract

Objective This study aims to compare between sublay hernioplasty and onlay hernioplasty in incisional hernia repair in diabetic patients. Background Incisional hernia is a common complication of abdominal surgery and an important source of morbidity. A wide spectrum of surgical techniques have been developed, ranging from suturing techniques to various types of prosthetic mesh repair. Use of a preperitoneal mesh repair technique showed a reduced number of postoperative complications and recurrence compared with other techniques. Materials and methods A prospective study was carried out on 30 diabetic patients who underwent incisional hernia repair with sublay hernioplasty or onlay hernioplasty between January 2012 and February 2013 in Sherbin Central Hospital and Menoufia University Hospital. The patients were divided into two equal groups (groups A and B). Patients in group A were treated with sublay repair, whereas patients in group B were treated with onlay repair. All patients underwent a preoperative assessment and postoperative follow-up. Outpatient clinical notes, discharge summary, operative notes, and laboratory data were reviewed. Results Sublay hernioplasty proved to be better with fewer complications compared with onlay hernioplasty. There was a statistically significant difference between the two groups regarding postoperative wound infection and seroma (40% in the onlay group; P > 0.0005). There was no statistically significant difference between two groups as regards postoperative recurrence (P < 0.0005). Conclusion Sublay mesh repair showed excellent short-term results, with minimal morbidity. It resulted in fewer postoperative complications and no recurrence. Compared with the onlay technique (in the literature) sublay mesh repair is a gold standard treatment for incisional hernia repair.

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