This is a distinct type of hernia which presents as a swelling in relation to any previous abdominal scar of surgery. This is due to weakness in the abdominal wall at the site of surgery, caused by the previous surgery. The chances of an incisional hernia are higher if the patient has had any wound infection in the surgical wound. There might be multiple defects along the length of the surgical scar. These herniae can grow to large sizes and are especially difficult to treat in patients who have had multiple surgeries at the same site. Since the abdominal wall musculature strength is already weakened due to previous surgeries, there are chances of recurrence of such herniae even following extensive surgery with mesh cover.
Surgical treatment for all Incisional herniae has to be planned meticulously.
Preoperatively, the patient has to be counseled about weight loss, control of diabetes and constipation if any and should abstain from smoking.
Postoperatively, it is imperative to avoid wound infection in all these cases. Any causes of increase in intra-abdominal pressure have to be avoided and the patient should not be allowed to carry heavy weights for at least 6 months after the surgery.The patient should wear a protective supportive belt for at least 3 months after the surgery.