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Abstract
Incisional hernia is a diffuse extrusion of the abdominal contents through a weak scar after an operation. It represents a partial abdominal dehiscence where the deep layers separate but the skin remains intact.
It has become a common complication after abdominal surgery and an important source of morbidity and mortality. The incidence of its occurrence has seriously increased over the past decade, jumping form 11%, as reported by, up to 20% percent of patients undergoing laparotomies, as notified in updated studies.
Many studies have shown that incisional hernias have different etiologies. Several factors are known to predispose to the development of incisional hernia. A number of these factors are specifically related to the performance of the operation. They include the type of incision, the type of suture, the suturing technique, the type closure, insertion of drains and postoperative wound infection.
In addition, a number of factors, related to specific patient characteristics or an underlying disease, correlate with the propensity to develop incisional hernias. These factors include old age, male gender, postoperative pulmonary complications, obesity, multiple pregnancies and general debilitating factors such as malnutrations, jaundice, ascetics, liver cirrhosis, peritoneal dialysis and concomitant steroid therapy.
Numerous authors have suggested that wound infection is the most important causative factor for the development of incisional hernia. Infection in the early postoperative period interferes with the normal process of surgical wound healing and may even lead to would failure with subsequent weakness of the incision.