Comparative analysis of onlay and sublay (retrorectus) mesh repair for incisional hernia (width ≤10 cm) of abdominal wall

A Comparative Study of Elective Sublay Versus Onlay Repair for Non-complex, Small, and Medium-Size Incisional Hernia: Post-operative Complications in a Tertiary Hospital in Ranchi, India

“…The incidence of incisional hernia had a female predominance of 60 (62.5%), with a male-to-female ratio of 0.6:1. This finding is compatible with the studies of Kumar et al, Saeed et al, Raghuveer et al, and Kumar et al [ 3 - 6 ]. This may be because females are more exposed to lower midline incisions, and overstretching of muscles during pregnancy, along with aging, causes laxity of muscle [ 3 ].…”

“…The mean age for the development of incisional hernia according to our study is 45. [4,6,10,12,15]. Out of the total 96 patients, 56 (58.40%) with incisional hernia had a previous history of emergency surgical procedures; this might be the consequence of surgical site infection followed by poor wound healing [6].…”

“…Incisional hernia, as the name suggests, occurs through the previous surgical scar and can occur anywhere in the anterior abdominal wall [ 12 ]; its incidence is in the range of 2-11% to 10-20% [ 4 ]. The risk of developing incisional hernia is high in patients with a history of previous surgical site infection [ 7 ], tension closure of the abdominal wall, and other factors like obesity, smoking, and diabetes [ 6 ].…”

“…Apart from the technique used for previous operations and wound infections, associated factors like obesity, smoking, and chronic medical conditions like diabetes and COPD all lead to the formation of incisional hernias [6][7][8].…”

“…The operative strategies used for the correction of incisional hernia have gradually progressed from anatomical repair, which has shown a high recurrence rate (31-49%), to mesh hernioplasty with less recurrence rate (≤10%) [ 6 ]. There are many studies that suggest that the position of the mesh has a major part in the outcome [ 9 ], because of postoperative complications like wound infection, seroma formation, and recurrence rate.…”