Clinical Features, Diagnosis, Prevention, and Management of Incisional Hernias

Abstract

The incidence of incisional hernia after intra-abdominal surgery is approximately 10–15%. Midline incisions are riskier than other incisions. Smoking, surgical site infections, conditions that impair wound healing, and incorrect surgical technique are among the risk factors, especially obesity. It typically presents as swelling on or near the incision. Computed tomography or ultrasonography can be performed for incisional hernias that cannot be detected by physical examination. Preoperative CT scan is important for the surgical strategy, especially for ventral hernias larger than 10 cm and with loss of space. The surgical strategy may vary depending on the size of the hernia. Tension-free repair is accepted as the standard approach by many authors, and suture repair alone is rarely used. The technique of separating into anterior or posterior components can be used in hernias larger than 10 cm with loss of space. Reconstruction using prosthesis material placed preperitoneally (underlay or sublay) is the most commonly used method today.