Volume : V, Issue : XI, November - 2015

Specific risk factors for Incisional Hernia

Dr. M. Ilaiah, Dr. K. Vijaya Kumar, Dr. V Siva Mohana Naidu

Abstract :

 Incisional hernia is iatrogenic and its incidence has increased with each increment of abdominal surgical intervention. An incisional hernia is the most perfect example of a “surgeon–dependent variable”. Laparoscopic surgery also added a new entity:“port site” hernia. This study aims at determining the association of incisional hernia in isolation, or in various combinations of specific risk factors such as sex, obesity, history of previous wound infection, the type of incision used and the number of previous operations. Methods : Fifty patients with incisional hernia admitted to Surgical wards of Osmania General Hospital form the material of this study. This is a longitudinal study. The study period is from September 2013 to September 2015. Patients were selected randomly. Detailed history with specific reference to previous surgery / surgeries and the postoperative period is elicited from the patient and verified with the previous records which are available with the patient. Results : Occurrence of incisional hernia appears to be multifactorial and these factors are inter–related. Association of one or more factors increases the predisposition to the incisional hernia. An attempt is made to study this inter relationship of these factors to the incidence of hernia using the Chi square test. Obese females have a specific predilection towards occurrence of incisional hernia as the P ~ 0.05. Our study sample is relatively small we feel a larger study is needed to emphasize this association more strongly. Obese patients are prone to wound infection, as 66.66 % of obese people had history of wound infection, as against 34 % of non– obese people. Obesity and wound infection show an association to incisional hernia with p < 0.05. Obese people with lower midline incision constitute 96.3% of cases and non obese with lower midline constitute 52% of cases. There appears a strong association between lower midline incision in an obese person to the occurrence of incisional hernia (p <0.05). Repeat surgery done through a lower midline incision resulted in incisional hernia in 68.4% of patients in our study where as repeat surgery done through other incisions resulted in 16% of cases, showing a strong association [P < 0.005). Conclusion : • Highest incidence of incisional hernia in the present series is between 31 –– 40 years. • Most of our patients were females. • Etiology is Multifactorial. • Postoperative wound infection at previous surgery seems to be a common predisposing factor. • Lower midline incision appears to have a special predilection towards incisional hernia. • Repeated surgery through the same incision has a role in theoccurrence of incisional hernia. • All these factors are interrelated. Presence of more than one factor ina patient shows increased predisposition to the incidence of incisional hernia. • Obese female have an increased predilection towards incisional hernia (p – 0.05) • Obesity is associated with more risk of postoperative wound infection and both resulted in an increased incidence of incisional hernia (p < 0.05) • Lower midline incision in obese people have a predilection or incisional hernia (P < 0.005) • Repeated surgery done through a lower midline incision carries an increased incidence of incisional hernia ( P < 0.005)

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Dr.M.Ilaiah, Dr.K.Vijaya Kumar, Dr.V Siva Mohana Naidu / Specific risk factors for Incisional Hernia / Indian Journal of Applied Research, Vol.5, Issue : 11 November 2015

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