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Meta-Analysis
. 2024 Sep;76(5):1685-1697.
doi: 10.1007/s13304-024-01755-0. Epub 2024 Feb 19.

A comparative study in elective repair of large incisional hernias using on-lay mesh vs. sub-lay mesh: a meta-analysis

Basma Hussein Abdelaziz Hassan  1 , Kirollos Adel Louiz Kamel  2 , Philobater Bahgat Adly Awad  2 , Kerolos Bahgat Adly Awad  2 , Sameh Abdallah Maaty  2 , Fawzi Salah Fawzi  2 , Bassem Helmy El-Shayeb  2
Affiliations
Meta-Analysis

A comparative study in elective repair of large incisional hernias using on-lay mesh vs. sub-lay mesh: a meta-analysis

Basma Hussein Abdelaziz Hassan et al. Updates Surg. 2024 Sep.

Abstract

Ventral abdominal wall incisional hernia is defined as a defect in the musculo-fascial layers of the abdominal wall in the region of the postoperative scar. There is a slight increase in the incidence of incisional hernia in the female gender. The higher percentage of incisional hernia in females might be due to laxity of abdominal wall muscles after multiple pregnancies and also an increased incidence of obesity in females. To assess incisional hernia repair using two different techniques: on-lay mesh and sub-lay mesh, as regards operative time, postoperative recurrence, wound infection, seroma, hematoma, and flap necrosis. Pubmed, Web of Science, and Scopus were searched on 15 March 2022. The keywords incisional hernia, sub-lay mesh on-lay mesh, retromuscular mesh, and polypropylene. According to our results, there is a statistical difference between onlay and sublay regarding intra-operative time as sublay mesh is more time-consuming. Regarding postoperative complications, there is no statistical difference in recurrence, seroma, hematoma, flap necrosis, and infection but there is a statistical difference regarding in hospital stay as patients with sub-lay repair stays less than only.

Keywords: Incisional hernia; Polypropylene; Retromuscular mesh; Sub-lay mesh on-lay mesh.

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Conflict of interest statement

I confirm that neither my colleague, I, nor any business with which I am associated has any personal or business interest or potential for personal gain from any of the organizations.

Figures

Fig. 1
Fig. 1
Shows PRISMA flowchart
Fig. 2
Fig. 2
Shows recurrence in onlay versus sublay
Fig. 3
Fig. 3
Shows infection in onlay versus sublay
Fig. 4
Fig. 4
Shows seroma in onlay versus sublay
Fig. 5
Fig. 5
Shows hematoma in onlay versus sub-lay
Fig. 6
Fig. 6
Shows flap necrosis in onlay versus sublay
Fig. 7
Fig. 7
Shows operative time in onlay versus sublay
Fig. 8
Fig. 8
Shows hospital stay in onlay versus sublay
Fig. 9
Fig. 9
Sensitivity
Fig. 10
Fig. 10
Shows sensitivity in recurrence
Fig. 11
Fig. 11
Shows sensitivity in hematoma
Fig. 12
Fig. 12
Shown sensitivity in flap necrosis
Fig. 13
Fig. 13
operative time sensitivity
Fig. 14
Fig. 14
Shows sensitivity in hospital stay
Fig. 15
Fig. 15
Infection
See this image and copyright information in PMC

References

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    1. Singh B, Jalthania MK, Kumari S (2019) A comparative study of various techniques of incisional hernia repair in a tertiary care center at Bikaner (North-West Rajasthan). Int Surg J 6(8):2909. 10.18203/2349-2902.isj20193341 - DOI
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