Incisional hernia: risk factors, clinical presentations, and pre-peritoneal polypropylene mesh repair

Background: Incisional hernia is a common surgical condition accounting for 15% to 20% of all abdominal wall hernias. Of all hernias, they can be the most frustrating and difficult to treat. Several technical and patient-related factors have been linked to their occurrence. There is no conclusive evidence that demonstrates that the type of suture or technique of incisional closure at the primary operation affects hernia formation. Recurrence rates (10-50%) and are typically reduced by more than half with the use of prosthetic mesh. People of all ages and ethnic backgrounds may develop an incisional hernia after abdominal surgery. This study was an effort to evaluate the risk factors, clinical presentations and polypropylene mesh repair (pre-peritoneal) management of incisional hernia.Methods: A total of 50 patients having incisional hernias admitted in our hospital between 2009 to 2011 have been studied. Strangulated, incarcerated, unfit patients with recurrent hernias and pregnancy have been excluded. Preperitoneal mesh repair was done in all the patients and follow up was done for 2 years.Results: Incisional hernia is more common in the obese and in middle aged females. Common risk factors are post op infection, obesity and multiparity. Most of the patients had incisional hernia within a year of previous surgery.Conclusions: Females are more prone. Most patients present as abdominal swelling with cough impulse and reducible on lying supine. Most of them occur within a year of previous surgery. Common risk factors include obesity, post op infections and multiparity.