Shoelace darn repair versus mesh repair hernioplasty in treating midline abdominal incisional hernia

ObjectiveThe objective of this study was to compare the efficiency and safety between the use of shoelace darn repair and the use of mesh repair in the management of midline abdominal incisional hernia.BackgroundMidline abdominal incisional hernia is a complication caused by surgical wounds after different surgical procedures. Management of midline abdominal incisional hernia is performed through different surgical approaches.Patients and methodsThis was a 1-year, prospective, randomized study including 40 patients with midline abdominal incisional hernia. The patients were divided into two equal groups - group I (20 patients) repaired by shoelace darn repair and group II (20 patients) repaired using a polypropylene mesh. Both groups were evaluated for incidence of infection, hematoma formation, seroma formation, and recurrence for 12 months.ResultsWound hematoma was found in one patient (5%) from group I and in one patient from group II (5%); there were no statistically significant differences between the two groups with regard to hematoma (P = 0.987). Similarly, seroma was found in one patient (5%) from group I and in one patient from group II (5%); there were no statistically significant differences between the two groups with regard to seroma (P = 0.987). Three patients (15%) from group I had recurrence of hernia, whereas two from group II had recurrence of hernia (10%), and statistical analysis proved that there was no significant difference between the two groups with regard to hernial recurrence (P = 0.637). One patient (5%) from group I complained of postoperative chronic pain, whereas two from group II (10%) complained of postoperative pain, and statistical analysis proved that there was no significant difference between the two groups with regard to postoperative chronic pain (P = 0.553). Wound infection was found in one patient (5%) from group I and in three patients from group II (15%), and statistical analysis proved that there was no significant difference between the two groups with regard to wound infection (P = 0.602).ConclusionFrom the present study, we concluded that shoelace darn repair is a better option for managing midline abdominal incisional hernias.