A retrospective study of predisposing factors and management of incisional hernia in a tertiary care hospital
DOI:
https://doi.org/10.18203/2349-2902.isj20242122Keywords:
Incisional hernia, Post-operative hernia, Scar herniaAbstract
Background: An incisional hernia is characterized as any defect in the abdominal wall, with or without a noticeable bulge, in the region of a postoperative scar, identifiable through clinical examination or imaging. This condition can be detected through clinical examination or imaging and affects approximately 10-20% of patients who undergo abdominal operations. Aims and objectives of the study was to evaluate various precipitating factors, clinical presentations, management and post-operative complications in patients with incisional hernia.
Methods: A retrospective study of 150 patients conducted at a tertiary care teaching hospital.
Results: In this study, incisional hernia was more common in obese, elderly, and female patients. The incidence was higher with Pfannenstiel incision followed by lower midline incisions. Incisional hernia was common between 1-5 years of index surgery and it was observed that more the risk factors and complications associated with index surgery, earlier was the onset of incisional hernia. Patients had a defect of size <4x4 cm were 58.66%. Open onlay mesh repair was done in 36.66% patients, preperitoneal mesh repair in 13.33%, retro rectus mesh repair in 13.33%, laparoscopic mesh repair in 28.66% and anatomical repair alone in 7.99% patients. Duration of laparoscopic surgery was longer compared to open. Most common post- operative complication was seroma (4.66%) followed by wound infection (2.66%).
Conclusions: Incisional hernias occur more in females as they commonly undergo lower abdominal surgeries. Subcutaneous suction drain decreased the incidence of post-operative wound complications.
Metrics
References
Shukla A, Ahmed S. Abdominal Incisional hernia: retrospective study. Int J Res Med Sci. 2018;6:2990-4.
Berrevoet F. Prevention of Incisional Hernias after Open Abdomen Treatment. Front Surg. 2018;5:11.
Henriksen NA, Deerenberg EB, Venclauskas L, Fortelny RH, Miserez M, Muysoms FE. Meta-analysis on materials and techniques for laparotomy closure: the match review. World J Surg. 2018;42(6):1666-78.
Burger JW, Luijendijk RW, Hop WC, et al. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg. 2004;240(3):578-83.
Kokotovic D, Bisgaard T, Helgstrand F. Long-term recurrence and complications associated with elective incisional hernia repair. JAMA. 2016;316(15):1575-82.
Kondareddy S, Nittala R. Incisional Hernia – A Prospective study of 50 cases for 1 year. Indian J Applied Res. 2011;4(5):403-7.
Sauerland S, Korenkov M, Kleinen T, Arndt M, Paul A. Obesity is a risk factor for recurrence after incisional hernia repair. Hernia. 2004;8(1):42e46.
Wijk L, Udumyan R, Pache B, et al. Incidence of incisional hernia following midline laparotomy and Pfannenstiel incision in patients with gynecologic cancer. Eur J Obstet Gynecol Reprod Biol. 2013;170(2):578-82.
Nick AM, Lange J, Frumovitz M. Risk factors for incisional hernia following midline laparotomy and Pfannenstiel incisions for gynecologic oncology procedures. Gynecol Oncol. 2015;136(3):484-9.
Ali AL, Sulaiman JN. The Low Transverse Abdominal Pfannenstiel Incision and the Prevalence of Incisional Hernia. Iraqi J Comm Med. 2011(2)
Thomas SA, Goel. Incisional hernia. Surgical Clinics of North America. 2019;73(3):557-68.
Misra MC, Bansal VK, Kulkarni MP, Pawar DK. Laparoscopic versus open incisional hernia repair: a randomized controlled trial. Surg Endosc. 2006;20(2):184-7.
Lall P, Khaira HS, Hunter B, Brown HJ. Repair of incisional hernias. Royal College of Surgeons Edinburgh. 2001;46:39-43.
Downloads
Published
How to Cite
Issue
Section
