Publication:

Comparative study of onlay versus preperitoneal mesh repair in umbilical hernia: a prospective observational analysis

Background Umbilical hernias-especially in women and patients with raised intra-abdominal pressure-pose a risk for postoperative seromas and infections. This study prospectively compares two mesh-based techniques: onlay versus preperitoneal placement.

Methods From January 2021 to December 2022, 50 adults with uncomplicated umbilical hernias were randomized to onlay (n=25) or preperitoneal (n=25) mesh repair. We monitored seroma formation, wound infection, flap necrosis, and length of hospital stay.

Results The onlay group experienced a 24% seroma rate and 24% wound-infection rate, plus one case of flap necrosis. The preperitoneal group had zero complications. Average hospital stay was 5.4 days in both arms.

Conclusions Preperitoneal mesh placement yields significantly fewer postoperative complications and should be the technique of choice for elective, uncomplicated umbilical hernia repair.