Comparison of Sublay Versus Onlay Mesh Repair in Patients With Ventral Hernia

Incisional hernias are the most common long-term complication of the midline laparotomy incisions, mostly repaired by ventral repair. This study aimed to compare the frequency of wound infection and seroma formation in patients undergoing onlay versus sublay mesh repair for ventral hernia. Methods:An Analytical cross-sectional study was conducted in the Surgical Unit of the University of Lahore Teaching Hospital from May 3, 2025 to November 3, 2025.A total of 140 patients were included and randomized into two groups: Group A (onlay mesh repair, n = 70) and Group B (sublay mesh repair, n = 70). Baseline demographics including age, gender, BMI, and socioeconomic status were recorded. All patients underwent standardized surgical procedures and were followed for 30 days postoperatively to assess wound infection and seroma formation. Data were analyzed using SPSS version 25.0. The Chi square test was applied, and a P-value of ≤ 0.05 was considered statistically significant. Results: Seroma formation occurred in 20.0% of patients in Group A compared with 5.7% in Group B. Wound infection was observed in 14.3% of patients in Group A and 2.9% in Group B. Both complications were significantly higher in the onlay repair group. Conclusion: Sublay mesh repair was associated with a lower incidence of wound infection and seroma formation when compared with onlay mesh repair. It may be considered a safer and more effective technique for ventral hernia repair.