Sublay mesh repair versus primary anatomical repair of strangulated ventral hernia: a prospective randomized controlled trial

Background Despite the high recurrence rate, the primary anatomical repair is considered the first line of treatment for strangulated ventral hernias (VH) to avoid high infection risk following the use of a nonabsorbable mesh in a potentially contaminated field. Objective To assess the use of sublay mesh repair in strangulated VH regarding postoperative wound complications and recurrence. Patients and methods This study was conducted on 90 patients aged more than 18 years old who presented with a strangulated VH at Mansoura University Hospitals during the period between September 2019 and September 2020. All included patients were randomized into two groups for doing hernia repair using sublay mesh repair or primary anatomical repair. Results Our results showed no statistically significant difference between both studied groups in terms of postoperative complications, pain, periods of hospital stay, and return to normal activity (P>0.5). Drain was removed after a relatively longer period in sublay mesh group and that difference was statistically significant. During the 6-month follow-up period, the recurrence rate was significantly higher in the primary anatomical group (six cases) than in the sublay mesh group (one case) (P=0.04). Conclusion We concluded that the sublay space does not carry an additional risk of complications but was found to have a beneficial effect of reducing recurrence in these patients.