Clinical study of incidence and surgical management of incisional hernia


  • Purushothaman Rangaswamy Department of General Surgery,ESIC Medical College and Hospital,Varatharajapuram, Coimbatore-641015,Tamil Nadu,India
  • Shaikh Afzal Rubby Department of General Surgery,ESIC Medical College and Hospital,Varatharajapuram, Coimbatore-641015,Tamil Nadu,India
  • Emmanuel Stephen J. Department of General Surgery,ESIC Medical College and Hospital,Varatharajapuram, Coimbatore-641015,Tamil Nadu,India



Anatomical repair, Incisional hernias, Surgical site Infections, Intra- abdominal pressure, Mesh


Background: Incisional hernia a common surgical problem, and uncommon sequel of surgical intervention. It occurs as a result of excessive tension and inadequate healing of previous incision, which is often associated with surgical site infection. We have studied here the etiology and risk factor for the development of incisional hernia. Various clinical presentations, incidence of incisional hernia and different therapeutic modalities of treatment and the post-operative complications. The main aim of the study was to identify the etiological factor to highlight the strategies for prevention of incisional hernias, to find the best management procedures for the incisional hernias.

Methods: The study is a perspective study was conducted in Meenakshi medical college and research institute, Kanchipuram for the period 2010-2012. 87 patients were included for the study. Patients who had herniation at site of previous surgery through the previous surgical scar were chosen for the study. Observations were made with regard to duration and ease of operation, wound complications, mesh infections, hospital stay, morbidity and recurrence.

Results: In our study 83% patients were women may be because of high incidence of caesarean section performed. As LSCS done through the lower midline incision was the commonest cause of incision hernias. The commonest age group was 4th decade that is from 30 - 40 years.

Conclusions: Incisional hernia is more seen in female, housewife who are multiparous, it is mostly presents with swelling and pain abdomen. Previous elective and emergency surgeries in lower midline have higher percentage of incisional hernia.


Werner S, Grose R. Inflammation: historical perspectives. In: inflammation: Basic Principles and Clinical Correlates, edited by Gallin JI, (New York: Raven Press) 5; 2003.

White TI, Santos MC, Thompson IS. Regulation of wound healing by growth factors and cytokines. Physical Review 83; 1998:53l-545.

Cross KJ, Mustoe TA. The anatomy of anterior abdominal wall, 2 editions, London, Edinburgh Churchill Livingstone; 2003:168-72.

De Vries Reilingh TS, Van Geldere D and Langenhorst B. Growth factors in wound healing. Surgical Clinics of North America. 2004;83:53l-45.

Chart R, Chart V and Eisenstat M. The neutrophil NADPH oxidase. Archives of Biochemistry and Biophysics. 2000:397 342.

Cichetti G, Allen PG, Glogauer M. A case control study of incisional hernia repair. Surgical Endoscopy. 2002;14:117-9.

Meyers M. Studies on inflammation: the effect on histamine and serotonin non vascular permeability: an electron microscopic study. J Biophy Biochem Cytol. 1994;11:571.

Butler P, Mitchell A, Ellis H. The anterior abdominal wall and peritoneum. In: applied radiological anatomy, edited by Cambridge University Press. 2003;189-200.

Tracey KJ. Illustrated review of diagnosis of abdominal wall hernias. British J Surg. 2002;86:1243-9.

Coakley FV, Hricak H. Chemotactic signalling pathways in neutrophils: from receptor to actin assembly. Critical Reviews Oral Bio Medi. 1999;13:220.

Majno G, Palade GE. A comparison of suture repair with mesh repair for incisional hernia. The New England J Med. 1961;343:392-8.

Stoppa RE. Seperation of anatomic components technique for the reconstruction of massive midline wall defects, Anatomy, Surgical techniques, Applications and Limitations revisited. Plast Reconstr Surg. 1989;105:731-8.

Anthony T, Bergen PC, Kim LT. Factors affecting recurrence following incisional herniorrhaphy. World J Surg. 2004;24:95-100.

Healy JC Reznekh. Repair of large midline incisional hernias with poly-propylene mesh: Comparison of three operative techniques. Hernia. 1999;8:56-9.

Sandblom G, Gruber Schluper I, Prescher A. Closure of the abdominal midline fascia: meta-analysis delineates the optimal technique. American Surgeon. 2000;67:421-6.

Combined fascia and mesh closure of large incisional hernias. J Royal College Surg Edinburgh. 2000;43:29-30.

Leber Garb JL, Alexander AI. Wound remodelling and scarring. J Wound Care. 1998;11:296.

Whitley MS, Ray-Chaudhuri SB, Galland RB. Factors affecting wound complications in repair of Incisional hernias. American Surg. 1998;64:276-80.

Massive incisional hernia: abdominal wall replacement with marlexmesh. British J Surg. 2000;78:242-4.

Tapper H. The treatment of complicated incisional hernias. World J Surg. 1996;13:545.






Original Research Articles