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• W2897916175 abstract "INTRODUCTION:Incisional hernia is the hernia that appears between the layers ofthe abdominal wall that develops in the scar of the surgical incision.Incisional Hernias make up about 80% of ventral hernias that surgeonsencounter. The range of incisional hernias rates after laprotomy is from2% to 11% which means that at least 150000 patients are going todevelop this complication from abdominal surgery.Once incisional hernia occurs, the natural history is for it to grow.Delay in repair complicates every single aspect of the surgery and leadsto increase morbidity. So repair should be done as soon as possible as. Asit grows the chances of complications such as in cacerations andstrangulation of viscera, atrophy of subcuteanous tissue, thinning of skin,ulceration of skin and loss of domain of the viscera occurs. The lateralabdominal muscles retract and become fibrotic and this enlarges thedefect. All these things greatly complicate any repair and increase thechance of repair failure and prosthetic infection and wound problems. Ifthe patient is obese weight loss makes the surgery easier. Closure is mucheasier with much lower recurrence rate. Excess skin and fat can beexcised which pleases the patient.AIM OF STUDY: 1.To identify the etiology, predisposing factors and contributing factorsfor the ventral incisional hernia.2.To find the incidence of incisional hernia following various abdominalincisions.3.Management of ventral incisional hernia.MATERIALS AND METHODS:This prospective study was conducted in Mahatma Gandhi Memorial Hospital, Trichy for the period of 2010 - 2012. Study of 50 cases of incisional hernia has been carried out under the guidance of Prof.Dr.A.Kanagasundaram MS my chief in Mahatma Gandhi Memorial Govt. Hospital, Trichy. Patients were considered eligible if they had an incisional hernia defined as the palpable fascia or muscle defect at the site of the previous abdominal incision. Hernias were detected clinically and assessed by ultrasonography.Certain aspects like obesity, anemia, diabetes, chronic bronchitis, hypertension and chronic constipation were particularly looked for.Clinical observation and statistical analysis follow up, results ofmesh repair were measured. The college ethics committee approved thestudy protocol. Routine laboratory investigations like urine, blood, chestscreening, electrocardiogram were done.OBSERVATIONS AND DISCUSSIONS:In our study 50 cases were studied over a period of 2 years. Highincidence of incisional hernias is seen in females when compared tomales .Since lower segment caesarean section is the most commonlydone surgery in females.Most of the incisional hernias is seen in middle age around 30 – 50years since these people was subjected to more surgeries and moreamount of stress like lifting heavy weight and also due to collagendisordersSince most of the incisional hernias occur through LSCS scar andthe incision is below the umbilicus and the defiency of the posteriorrectus sheath predisposes to this and also more common amongemergency proceduresWound infection in the post operative period is the most commoncomplication met in repair of incisional hernia since the seroma is thecause for the same due to excessive handling of subcutaneous tissue .occurrence of the incisional hernia is seen in the first three years ofprevious surgery since the lack of adequate rest is the reason for thisoccurrence 22 patients presented with swelling and 13 patients presentedwith pain in our study .Most of the repair done in our hospital are onlay mesh repair sincethe rate of recurrence is less after mesh repair when compared toanatomical repair.CONCLUSION:Careful analysis of the current surgical literature including fourrecently published meta analyses indicates that a consistent conclusioncan be made regarding an optimal technique. The abdominal closuretechnique should be fast, easy and cost effective while preventing bothearly and late complications. The technique involves mass closureincorporating all the layers of abdominal wall (except skin) as onestructure in a simple running technique using 1-0 or 2-0 absorbablemonofilament suture material with a suture length to wound length ratioof 4:1.Use of mesh has drastically reduced the rate of recurrence ofincisional hernia. Mesh repair is the gold standard for the treatment ofincisional hernias.We should all remember that incisional hernia is a preventablesurgical complication." @default.
• W2897916175 created "2018-10-26" @default.
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• W2897916175 date "2013-04-01" @default.
• W2897916175 modified "2023-09-27" @default.
• W2897916175 title "A Comprehensive study on Incidence and Management of Incisional Hernias" @default.
• W2897916175 hasPublicationYear "2013" @default.
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