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Gaurav Prasad, S. N. Shirbur* and Srinivasan D.


Background: The objective of the study was to reassess the efficacy of the open onlay technique for repair of incision hernia, utilizing the modern adjuncts of components separation and fibrin sealant to reduce the principal complications of seroma and recurrence. Methods: A retrospective audit was applied to 116 patients undergoing open onlay incisional hernia repair during a 2-year period at a single institution. Information was collected concerning operative details, postoperative complications, and recurrence. Clinical review at a median 15.2 months postoperatively was followed in OPD with structured questionnaire to assess quality of life. All patients with pain or suspected recurrence were recalled for examination. Results: Fascial closure required components separation in 21 (18.1%) patients when tension-free fascia reconstruction was not possible, The fibrin sealant was applied in 22 (18.9%) in whom extensive skin flaps were dissected beyond the semilunar line. Postoperatively, there were 11 (9.5%) seromas and 2 (1.7%) deep wound infections. At 15.2 months’ follow-up there were 4 (3.4%) recurrences. Conclusions Open onlay mesh repair for ventral hernia is a versatile operation applicable to all quadrants of the abdominal wall and gives excellent results when used in association with components separation and fibrin sealant.

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