Comparative Study in Repair Large Abdominal Wall Defect between Modified Darning Technique and Mesh Repair
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Abstract
BACKGROUND: Incisional hernia of the abdominal wall occurs in approximately 12.6% at 1 year, 12.8% at 2 years after surgery, and 22.4% at 3 years after surgery. After surgical repair, the recurrence rate is as high as 14-73%, which is a significant challenge for surgeons in solving the problem for their patients.
OBJECTIVES: This study aims to evaluate the effectiveness and cost implications of a novel surgical technique-Modified Darning Repair (MDR)-developed to repair large abdominal wall defects without the use of mesh comparing to standard Open Mesh Repair (OMR).
METHODS: A retrospective review was conducted on patients who underwent elective repair for large abdominal wall defects at Sisaket Hospital between 2019 and 2022.
RESULTS: The study compares between 5 patients of MDR and 5 patients of OMR reveals that MDR offers comparable clinical outcomes to OMR such as Length of stay (p=1.00), operative times (p=0.82), and use of injectable pain medication (p=1.00) while reducing costs (16,542 vs. 28,927 THB), highlighting its potential as a viable alternative in resource-limited settings.
CONCLUSIONS: The Modified Darning Repair (MDR) technique may serve as a cost-effective alternative to mesh repair for large incisional hernias, particularly in settings with limited resources. Further research is needed to validate these findings through prospective studies.
Thaiclinicaltrials.org number, TCTR20241009002
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