A study of etiology, clinical presentation and management of incisional hernia

Background: Incisional hernia is a common condition encountered by General surgeons. This study was undertaken to identify the etiology, clinical presentations, management and outcome of incisional hernia. Method: An observational Prospective study of 40 patients with incisional hernia presented in surgery outpatient department at a tertiary care centre during period of one year were enrolled and analyzed. Results: Incisional hernia was commonest in the fifth decade of life (32.5%) with female predominance (67.5%). Swelling (80%) at previous incision site is commonest clinical presentation followed by pain (20%). Majority cases had history of previous pelvic surgeries (62.5%) with Pfannenstiel incision was commonest incision (45%).Wound infection (37.5%) was a predominant risk factor and also diabetes mellitus (35%), hypertension (25%) and obesity (20%) act as predisposing factors for incisional hernia. Size of the hernia defect was less than 2 cm in (47.5%) of patients and more than 2 cm in (52.5%) patients. Incisional hernias repair were performed by open method by using mesh in (72.5%) and laparoscopic repair in (27.5%) patients. Patient with Laparoscopic hernia repair had less duration of hospital stay compared to open repair. Wound infection (12.5%) was the commonest postoperative complication followed by seroma formation and respiratory tract infection. Conclusion: Wound infection is commonest predisposing factor and Swelling at previous scar is most common clinical presentation of incisional hernia. Mesh repair is most common procedure performed for incisional hernia. Patients with laparoscopic hernia repair had shorter hospital stay and early resumption to work.