A Comparative Study of Tissue versus Mesh Repair for Abdominal Incisional Hernia - Jammu Kashmir Experience

Aims: To evaluate and compare the efficacy of Tissue versus Mesh repair in mid-line abdominal incisional hernia in Jammu and Kashmir population. Methods: This study was conducted in the Departments of Surgery, Government Medical College Srinagar and Jammu from January 2003 to September 2012. It was a prospective study whereby a total of 50 patients with abdominal incisional hernia were taken. Out of 50 patients, 25 patients were taken for Mesh (polypropylene) repair and 25 for Tissue (shoelace technique) repair from January 2003 to September 2005. The patients were followed every 2, 4, 6, 12 weeks and thereafter every 6 months for any discharge, sinus formation, recurrence etc. Results: The median follow-up was 90 months for tissue repair group and 94 months in mesh repair group. The total operating time was more in tissue repair group. Post-operative pain using VAS was more in mesh repair group. Wound hematomas were almost same in both the groups whereas wound seroma and wound infection was more in mesh repair group. Recurrence rate was high in tissue repair group after a prolonged follow up. Conclusion: The comparative analysis revealed that as the rate of recurrence was more in tissue repair group, the mesh repair was superior to it. It also revealed that mesh repair should not be undertaken in emergency incisional hernia surgery as the chances of mesh infection are high and as such the recurrence.