Which mesh site is best in the repair of incisional hernia?

ABSTRACT

20 patients 12 males, 8 females with age 35_8 with huge oval incisional hernia were subjected to four methods of mesh implantation. Anatomical reconstruction was found difficult in those patients. They were divided into four groups each comprised 5 patients 1st group subjected to on lay of mesh application [Fig.1]. 2nd group subjected to subfascial extraperitoneal mesh application [Fig. 2]. 3 th group subjected to subfascial intraperitoneal mesh application [Fig. 3]. 4th group subjected to the application of two mesh grafts one extrafascial and the other intraperitoneal [Fig. 4]. Ml patients were put under the same preoperative regime and strict aseptic technique. Recurrence occurred in 2 patients in gp, 1.2 patients in group III and 1 patients in group IV, fecal fistula developed in one patient in group I. No recureence ocucrred in group II. Mild wound infection developed in 2 patients in group I, 1 patient in group III and 1 patient in group IV. Severe wound infection developed in one patient in group 1, this necessiated removal of the mesh under general anaesthesia also severe infection developed in one patient of group IV but was controlled by drainage