Comparison of Post-Operative Pain and Complications between Onlay and Sublay Mesh Repair of Incisional Hernia in Tertiary Care Hospital in Pakistan
DOI:
https://doi.org/10.51985/Keywords:
Hematoma, Pain, Postoperative Complications, Surgical Mesh, Seroma, Wound InfectionAbstract
Objective: To assess and compare postoperative pain and complications between onlay and sublay mesh repair for incisional hernias.
Study Design and Setting: It is a Prospective Observational Study conducted at Department of Surgery, JPMC Karachi. Duration of study spanned from January to June 2025.
Methodology: 50 patients with incisional hernias either underwent onlay (Group A) or sublay (Group B) repair. Age, symptom duration, procedure duration, weight, height, and BMI were characterized using mean ± SD. Gender, ASA grade, and post-operative complication (hematoma, seroma and wound infection) were presented as frequencies and percentages. Pain was gauged using Visual analog score (VAS) at 2nd hour post-op, 24th hour, and discharge. A Chi-square test was utilized, with p = 0.05. A paired t-test was used to compare pre and postoperative pain score between group A and B, with p = 0.05.
Results: In Onlay group, incidence of wound infections were 8%, hematoma was 12%, and seroma was 16%. In sublay group, incidence of wound infections were 4%, hematoma was 8%, and seroma was 4%. In Group A, VAS was 8.2 in 2nd hour, 3.9 in 24th hour, and 1.9 at discharge. In Group B, VAS was 6.4 in 2nd hour, 3.2 in 24th hour, and 0.8 at discharge. The results were statistically significant.
Conclusion: Group B demonstrated better postoperative outcomes and lower VAS scores. Incidences of wound infection, hematoma, and seroma were lower in group B. This research contributes to valuable evidence favoring the sublay approach as more effective surgical strategy
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Copyright (c) 2026 Beenish Khan, Rabel Qureshi, Priya Bai, Mazhar Iqbal (Author)

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