Use of a combined sublay–onlay “sandwich” technique for abdominal incisional hernia repair: a case report
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By
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Xing-Kai Kang
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Bin Wu
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Jing Wang
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Yi-Zhou Shao
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Tao Wang
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July 7, 2026
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Clinical Scorecard: Application of a Dual-layer “Sandwich” Approach for Repairing Abdominal Incisional Hernias: A Case Study
At a Glance
| Category | Detail |
|---|
| Condition | Abdominal Incisional Hernia |
| Key Mechanisms | Double-layer polypropylene patch repair technique combining sublay and onlay placement. |
| Target Population | Patients with giant incisional hernias, specifically those with abdominal wall defects greater than 10 cm. |
| Care Setting | Surgical intervention in a hospital setting. |
Key Highlights
- Giant incisional hernias can complicate treatment planning due to large abdominal defects.
- The 'sandwich' technique improves abdominal wall stability compared to traditional single-layer repairs.
- The patient achieved good postoperative recovery with no recurrence at 6-month follow-up.
Guideline-Based Recommendations
Diagnosis
- Utilize the European Hernia Society classification system for abdominal wall defects.
Management
- Consider double-layer mesh techniques for large incisional hernias to reduce recurrence rates.
Monitoring & Follow-up
- Follow-up assessments should be conducted to evaluate for recurrence and overall recovery.
Risks
- High tension in traditional repairs can lead to recurrence rates of 30%-50%.
Patient & Prescribing Data
76-year-old female with a history of abdominal surgery and a giant incisional hernia.
The use of a dual-layer mesh approach was effective in managing a significant abdominal wall defect.
Clinical Best Practices
- Individualize treatment based on defect size, location, and patient condition.
- Employ negative-pressure drainage to prevent fluid accumulation post-surgery.
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