Abdul Malik Magsi, Mariam Malik, Kehkashan Anwar, Ahmed Usman Rafi.
A Comparison between Sub-lay and On-lay Mesh Repair in Incisional Hernia: a Randomized Controlled Trial.
Isra Med J Jan ;13(4):255-60.

Objective: To compare frequency of post incisional hernia repair complications in view of on-lay and sub-lay mesh repair. Study Design: Randomized Controlled Trial Place and Duration: Surgery Department Jinnah Postgraduate Medical Centre, Karachi from 10th October 2018 to 10th April 2019. Methodology: Patients from both genders with incisional hernia for more than 6 months, ASA grade I and II were included. Patients were randomly assigned by non-probability consecutive sampling into one of two groups of 30 patients each. Group A, patients had on-lay mesh repair and group B patient received sub-lay mesh repair. Patients were called for follow up on 15th day to assess the postoperative complications i.e.; wound infection, hematoma and seroma. Results: Among total of 60 patients, each group (Group A and B) comprises of 30 patients each and female gender was dominant in both group (53.3% and 76.7%). In both groups 26.7% patients were diabetics. In Group- A, wound infection was observed in 6.7% patients as compare to 13.3% patients in sub-lay mesh repair Group- B (P=0.389). In on-lay mesh repair group hematoma was noticed in 6.7% patients as compare to 16.7% patients in sub-lay mesh repair group (P=0.227). In Group- A seroma was seen in 13.3% patients whereas, in 3.3% patient in Group- B (P=0.161). Conclusion: There was no significant difference regarding post-operative complications with on-lay and sub-lay mesh method in repair of incisional hernia with acceptable complication rates.

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