ABSTRACT
Background: More than 1 million ventral hernia surgeries are done annually in India. Suture repair techniques have dominated ventral and incisional hernia repair over a century. The most popular of these techniques was the Mayo duplication. In larger hernias, suture repair requires the application of tension to the fascia in order to close the orifice. The aim of the study: This study aimed to compare the duration of surgery and postoperative complications of subway and only meshplasty in the treatment of ventral hernias. Materials and methods: This study was conducted in the Department of General Surgery, Government Stanley Medical College, Chennai in 2018. Totally 50 cases were included in the study. Group A (25 Cases- Onlay meshplasty) Group B (25 cases - Sublay meshplasty). All subjects undergoing onlay and sub lay mesh repair for ventral hernias were evaluated intraoperatively for the duration of surgery and postoperatively for complications like surgical site infections, seroma formation, flap necrosis and duration of hospital stay. Results: The most common complication observed was seroma in 6 patients. 1(4%) were in preperitoneal and 4(20%) in the onlay mesh repair group. This complication was managed with seroma drainage. The only technique had more of seroma formation, due to the fact that onlay techniques require significant subcutaneous dissection to place the mesh, which can lead to devitalized tissue with seroma formation or infection. The superficial location of the mesh also puts it in danger of becoming infected if there is superficial wound infection. Wound infection was found in 5 cases. Out of these, 1(4%) were in a pre-peritoneal group and 4(16%) were in onlay group. These patients were Manimegalai, Avvait. A comparative study between onlay and subway mesh repair in the treatment of ventral hernia. IAIM, 2019; 6(3): 217-222. Page 218 treated with appropriate antibiotics and regular dressing. No patient required removal of mesh because the infection was superficial and responded well to antibiotics. Conclusion: Sublay mesh repair is a good alternative to onlay mesh repair that may be applicable to all forms of ventral hernia as the mesh related overall complication rate like a seroma, surgical site infections, flap necrosis, and hospital stay are less compared to onlay mesh plasty.