Small incisional hernias recur 2% to 5% of the time; medium-sized hernias recur 5% to 15% of the time; and large hernias may recur up to 50% of the time (Deveney 765).Subsequent repair incisional hernias results in consistently poor outcomes due to continued weakening of the abdominal wall. 2009 Send us comments, suggestions, corrections, or anything you would like us to hear.
The wound eventually reopens (dehiscence), allowing the abdominal organs to bulge through the incision site.Normal tissue is replaced by scar tissue along the incision as part of the healing process, but scar tissue is not as strong and is more subject to tears.When the scar tissue thins or stretches, it weakens and may rupture when intra-abdominal pressure comes to bear upon it.In addition, a bulge may appear in the abdomen near the incisional site, accompanied by a dull, aching sensation.Swelling may be the only noticeable condition, with no other symptoms reported.Gender and race are not risk factors for this type of hernia.
History: The individual may complain of pain in the area near incision from a previous abdominal operation.
If the individual does not want surgery or is a poor risk for the procedure, manual reduction may be performed followed by use of an elastic corset to support the weakened area and control symptoms.
The outcome for open surgical treatment of incisional hernia depends primarily on the size of the hernia, the organ that has protruded through the weakened fascia, and the tension that remains on the incision line following surgery.
An incisional hernia usually can be identified from bulging or weakness in the area of a surgical incision.
The extent of the herniation (fascial defect and identification of hernial sac) usually can be felt by hand (palpated).
The material used to close the incision also may contribute to incisional hernia, as may poor wound closure technique.