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Incisional hernia: a review.

J M Adotey1

  • 1Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.

Nigerian Journal of Medicine : Journal of the National Association of Resident Doctors of Nigeria
|May 3, 2006
PubMed
Summary

Incisional hernias are common after abdominal surgery, with wound infection significantly increasing their incidence. While prosthetic mesh and laparoscopic techniques improve repair outcomes, incisional herniation remains a challenge for surgeons.

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Area of Science:

  • Abdominal Surgery
  • Surgical Complications
  • Hernia Repair

Background:

  • Incisional hernia, or post-operative ventral hernia, is a frequent complication of abdominal surgery.
  • It represents a significant cause of patient morbidity.
  • This review provides a historical overview and current perspective on incisional hernias.

Purpose of the Study:

  • To review the incidence, causative factors, and management of incisional hernias.
  • To compare different surgical repair techniques and their outcomes.
  • To highlight the persistent challenges in incisional hernia management.

Main Methods:

  • A comprehensive literature review was conducted.
  • Searches included manual library searches and online databases (PubMed, Medline).
  • Relevant articles and their reference lists were systematically studied.

Main Results:

  • Incisional hernia incidence is ~1% with primary healing, rising to ~11% with wound infection and ~30% after wound dehiscence and resuture.
  • Wound infection is the most consistent causative factor.
  • Prosthetic mesh repair, both open and laparoscopic, offers significantly lower recurrence rates (0-10% and 0-9%) compared to direct suture repair (up to 49%). Laparoscopic repair is feasible, safe, and effective.

Conclusions:

  • Despite advancements in surgical techniques and the use of prosthetic mesh, incisional hernias continue to pose a significant problem for general surgeons.
  • Improved outcomes are noted with mesh-augmented repairs, but recurrence remains a concern.

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