A retrospective study of predisposing factors and management of incisional hernia in a tertiary care hospital

Background: An incisional hernia is characterized as any defect in the abdominal wall, with or without a noticeable bulge, in the region of a postoperative scar, identifiable through clinical examination or imaging. This condition can be detected through clinical examination or imaging and affects approximately 10-20% of patients who undergo abdominal operations. Aims and objectives of the study was to evaluate various precipitating factors, clinical presentations, management and post-operative complications in patients with incisional hernia. Methods: A retrospective study of 150 patients conducted at a tertiary care teaching hospital. Results: In this study, incisional hernia was more common in obese, elderly, and female patients. The incidence was higher with Pfannenstiel incision followed by lower midline incisions. Incisional hernia was common between 1-5 years of index surgery and it was observed that more the risk factors and complications associated with index surgery, earlier was the onset of incisional hernia. Patients had a defect of size <4x4 cm were 58.66%. Open onlay mesh repair was done in 36.66% patients, preperitoneal mesh repair in 13.33%, retro rectus mesh repair in 13.33%, laparoscopic mesh repair in 28.66% and anatomical repair alone in 7.99% patients. Duration of laparoscopic surgery was longer compared to open. Most common post- operative complication was seroma (4.66%) followed by wound infection (2.66%). Conclusions: Incisional hernias occur more in females as they commonly undergo lower abdominal surgeries. Subcutaneous suction drain decreased the incidence of post-operative wound complications.