Incisional hernias (alternative plural: herniae) are relatively common and along with parastomal hernias, umbilical hernias, paraumbilical hernias, and Spigelian hernias, they are usually anterior abdominal hernias.
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Epidemiology
Incisional hernias usually develop within a few months of surgery, but a small proportion can remain clinically silent for years. They typically occur after laparotomy with rates of ~2-20% 5.
Risk factors
Numerous risk factors for developing an incisional hernia have been identified 4:
preoperative factors: increasing age, female gender, BMI >25, increasing thickness of subcutaneous fat based on CT, preoperative chemotherapy
intraoperative factors: midline incision, contaminated or infected wound noted during the procedure, intraoperative blood loss
postoperative factors: surgical site infection
Pathology
Incisional hernias occur most frequently through previous laparotomy scars (other incisional hernias are possible, such as a lung hernia). Widening or dehiscence of the scar allows intra-abdominal contents to herniate into the subcutaneous tissues.
Treatment and prognosis
Current literature endorses that surgical repair for incisional hernia is taken up to cause improvement in the quality of life of patients 5.
Complications
Complications are similar to other hernias and include incarceration, strangulation and intestinal obstruction.
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