INCISIONAL HERNIAS

Abstract

Incisional herniasare one of the major problems in general surgery. Prosthetic and suture materials have been used to decrease the recurrence rates. These materials have been utilized increasingly in the last decade. So, the recurrence rate of incisional hernia has been decreased by the use of these materials. Three hundred and thirty-four patients who were operated for incisional hernia between January 1988 and December 1999 were retrospectively investigated. Eighty-eight (26.3%) patients were male and 246 (73.7%) were female. Concomitant diseases were found in 168 (50.2%) patients, in previous operations incisional hernia was reported in 94 (28%) patients. Surgical site infection has been observed in 192 (57.4%) patients after primary surgery. Mean dimensions of fascia defects were 27.8cm2 (2-400 cm2) and 68 patients (20.3%) had multiple fascia defects, Two hundred and thirty patients were repaired with prosthetic materials and 104 patients with primary closure. Superficial or deep surgical site infections developed postoperatively in 36 (10.7%) patients. Infection was seen in 19(8.2%) patients of prosthetic hernioraphy group and in 17 (16.3%) patients primary closure group. Seroma was postoperatively developed in 22 (6.5%) patients in prosthetic hernioraphy group and 4 (3.8%) patients in primary closure. Haematoma developed only in 6 (5.7%) patients in the primary closure group. Recurrence rate was 18% and 3% in primary closure and prosthetic hernioraphy group respectively. Complicated or/and recurrent incisional hernia repair with prosthetic moterial is safe and have low recurrence and postoperative complication rates. Taking preventive measures for surgical site infections may reduce the recurrence rates.