A clinical study on incisional hernia

INTRODUCTION: Incisional hernia is a hernia arising from previous surgical or wound site. Incisional hernia constitutes 2% – 12 % of all abdominal surgical incisions. There are many surgical techniques are available but no one is best always. AIM & OBJECTIVE: To evaluate the incidence of incisional hernia and to compare the various surgical techniques to repair the incisional hernia. MATERIALS & METHODS: This prospective study of 60 consecutive cases of incisional hernia admitted in Government Mohan Kumaramangalam Medical College Hospital, Salem was done in the period from July 2011 to June 2013. The cases were evaluated through proper history taking, clinical examination, operative procedure and post operative follow-ups. OBSERVATION: In our study, commonest age group having incisional hernia is between 30 – 50 years (46.6%). Females are common (61.7%), the most common previous surgery to develop the incisional hernia is Laparotomy (58.3%) and common surgical incision is Median Vertical (45.1%). Most of the patients (27.3%) had wound dehiscence. 47% of patient had incisional hernia within one year of previous surgery. In this study, I found 10% of recurrence rate, 25% of per operative bleeding and 25% of chronic pain for onlay mesh repair. Sublay, Component Separation Techinique and Laparoscopic technique had no recurrence; Chronic pain was noticed 10% patients in Component Separation and Laparoscopic techniques while only 5% patients in Sublay repair.Hospital stay is less required in sublay repairs and laparoscopic repairs. Sublay technique had less post operative complication. CONCLUSION: Open Sublay mesh repair and Laparoscopic mesh repair are the best method in our study compared to others. Middle aged female patients who underwent laparotomy with wound dehiscence having midline vertical incision had incisional hernia commonly.