A prospective analytical study on epidemiology and management of incisional hernia

Abstract

Introduction: A hernia is the protrusion of viscous or a part of viscous through a normal or abnormal opening in the wall of its containing cavity. A ventral hernia is any hernia protruding through the abdominal wall, while Incisional hernia (IH) is a hernia protruding through an operational scar. According to the various studies abdominal surgeries have 11% to 19% chance of developing IH. Materials and Methods: The study is a prospective study and study group was patients admitted and operated in Bidar Institute of Medical Science, Bidar Karnataka from April 2019 to December 2020. Total 75 cases of various types of hernias operated. Out of 30 cases of incisional hernias were included in this group for study. In this series patients admitted in surgical wards under all surgical units were examined to assess the abdominal wall defects, etiological and predisposing factors. A detailed case history and thorough clinical examination was done to determine the type and cause of hernia and necessary investigations were done according to proforma. After detailed physical examination of patients, clinical diagnosis was established including the associated etiological and predisposing factors. Results: During the period of our study, a total of 75 patients have been operated for various types of hernia, out of these 30 cases were incisional hernia. Inguinal hernia was most common type accounting for 42.66%, next common hernia was incisional hernia (40%) remaining rare type of hernias constituting 17.34% of total cases studied. Maximum number of cases in middle age group (30-60 yrs.) constituting 80%. Incisional hernia was found to be more common in females with male female ratio of 1:2.3. Conclusion: Mesh repair results in less recurrence than anatomical repair for incisional hernia. The incidence of incisional hernia is more common in women than men due to abdominal wall weakness secondary to multiple pregnancies, increased number of caesarean sections and gynaecological surgeries. Sterile aseptic technique and appropriate use of pre-operative antibiotics is necessary to reduce the occurrence of incisional hernia.