Evaluation of a Component Release Approach in Incisional Hernia Repair Accompanied with Onlay Mesh Reinforcement

Background: Large midline incisional hernia with loss of domain is difficult to repair, especially when midline closure cannot be achieved without tension. Component separation combined with onlay mesh reinforcement has been used to restore abdominal wall integrity normal physiological function and improve functional outcomes. Aim: To assess the feasibility, safety and evaluate the outcomes of repairing large incisional hernias using abdominal wall component release approach accompanied with onlay mesh fixation. Patients and Methods: Twelve patients with sizable midline incisional hernias were enrolled in a prospective cohort. All underwent component separation with onlay mesh after standard preoperative optimization. Operative findings, postoperative complications, hospital stay and quality-of-life (QoL) scores were monitored for 5–10 months. Results: Minor postoperative complications occurred, mainly mild seroma (41.7%) and wound ischemia, infection in two patient (16.7%). No mesh infections, fistulas, abdominal compartment syndrome or early recurrences were documented. Mean hospital stay was 7.9 ± 5.0 days. QoL improved significantly, with total EuraHS scores. Conclusion: Component separation with contemporary onlay mesh fixation is a feasible and safe option for large midline incisional hernias, offering acceptable complication rates, clear functional improvement and no early recurrence in this research.