Etiology and risk factors of incisional hernia – A prospective study

Abstract

Background: Incisional hernia is an iatrogenic defect in the abdominal wall that occurs in the site of previous incision. The study was conducted to analyze the etiology and risk factors of incisional hernia. Materials and Methods: The study was conducted in our hospital in the Department of General Surgery from October 2018 to September 2020. All patients who attended the outpatient department with incisional hernia were admitted based on inclusion and exclusion criteria and evaluated. The etiology and risk factors such as age, sex, Precipitating factors, nature of previous surgery were evaluated with proper history and investigations and results were correlated with other studies. Results: The incisional hernia patients commonly presented in the age group of 31 to 50 years of age and among them female has increased propensity. Obesity is considered as a major risk factor for both males and females accounts for 84% of our study and 32% of patients with incisional hernia are smokers who are entirely males. The incidence of incisional hernia has been increased following gynecological procedures (66%) and lower midline scar (32%) following previous surgery. The wound infection being an important risk factor for incisional hernia, in our study, only 12% of cases had a history of wound infection following previous procedure. Other risk factors includes Diabetes mellitus (28%), Anemia (26%), immunosuppression also predispose to incisional hernia were observed and all these factors have strong association with incisional hernia and p-value less than 0.05 which is significant. Patient treated with onlay meshplasty had showed better outcome. No recurrence during follow up period. Conclusion: Incisional hernia must be kept in mind in all abdominal surgeries and care must be taken prior to occurrence of incisional hernia by assessing the risk factors and correcting the modifiable risk factors prior to any surgeries. Meshplasty is the management of choice with less recurrence.