Incisional Hernia, risk factors, management and relation to Surgical Abdominal Incisions

Background: Incisional hernia is a hernia that protrudes through a defect in a previous abdominal wound, and is one of the complications after abdominal surgery. Many risk factors seem to be associated with its development, and there are different treatment modalities from conservative management to operative repair whether open or laparoscopic. Objective: To assess the relation between the type of surgical abdominal incision, and the occurrence of incisional hernia. Patients and Methods: A prospective study of 70 patients (58 cases: female, and 12 cases: male) diagnosed as having abdominal incisional hernia, admitted to the Surgical Department of Sulaimaniyah Teaching Hospital during the period from 1 May 2011 to 30 November 2012. History was taken and physical examination was done for all the patients. Modes of repairs for incisional hernia have been reported. Results: Transverse incisions (including Pfannenstiel) were more prone for incisional hernia about 30 cases (42.86%) whereas vertical incisions developed in 25 cases (35.71%) and only 11 cases (15.71%) were oblique incisions. Conclusion: We found that transverse incisions and elective cases were more prone for incisional hernia. Obesity and wound infection also play an important role in the development of incisional hernia. Now mesh repair is the modality of choice which is used frequently in our cases which was 68.57% of all incisional hernia cases.