1.4.3 Incisional hernia
Incisional hernias occur after open surgical procedures on the abdomen in the region of the surgical scar. This type of hernia is seen after some 10 % of all abdominal operations. Based on data from the German Federal Statistical Agency, around 50,000 incisional hernia surgical procedures are carried out each year in Germany (!).
Incisional hernias arise because of a lack of strength of the surgical scar. Contributory factors include wound infection, bleeding, impaired wound healing, patient’s poor general and nutritional status, special diseases such as diabetes or cancer, overweight, medications (in particular cortisone preparations), long-standing nicotine consumption as well as defective collagen metabolism. Incisional hernia generally presents within one year of abdominal surgery. The main symptom is a visible or palpable protrusion in the region of a still relatively fresh abdominal surgical scar.
Even if an incisional hernia does not give rise to any complaints, it should nonetheless be operated on since it could cause dangerous complications, in particular strangulation of intestinal components. However, the original surgical scar should be first allowed to heal, something that in general takes around six months after the procedure.