European Journal of Molecular & Clinical Medicine

BACKGROUND: Incisional hernia is the hernia that presents at the site of a previous incision. It is one true iatrogenic hernia. Study of its clinical presentation and management may help its prevention. This study was performed to review clinical profile and management of incisional hernia in our institute.
METHODS: This study was conducted in the Department of General Surgery at KIMSDU, Karad. 60 patients underwent surgery for incisional hernia. Data on clinical presentation, type of operative procedure, and post-operative complications were collected.
RESULTS: 60 cases underwent surgery for an incisional hernia, female predominance, and age group of 35-45 years and 56-65 were common, about 9(15%) of patients had pre-operative pain,  the most common previous surgery was LSCS 23(38.33%), the most common surgical incision was Pfannenstiel 27(45%), more common in the infraumbilical region (83.33%), 7(11.67%) had post op SSI, major comorbidity was obesity, most common operative management was sublay (preperitoneal) meshplasty.
CONCLUSION: Incisional hernia is more common in females.. In our study most of the incisional hernia occurred in infraumbilical incisions. Patients with comorbidities such as obesity, diabetes mellitus, COPD had higher chances of hernia occurrence.

Introduction: Umbilical hernias in adults are commonly acquired hernias. These are more common in women, and in conditions like pregnancy, ascites, obesity etc. More than 1 million hernia surgeries are done annually in India. Suture repair techniques have dominated ventral and incisional hernia repair over a century. The most popular of these techniques was the Mayo duplication. In larger hernias, suture repair requires the application of tension to the fascia in order to close the orifice.
Objectives of the study: To evaluate the outcome of onlay and pre-peritoneal open mesh repair in umbilical hernias in adults regarding operative time, ease of procedure, hospital stay, complications and recurrence if any.

Background:The present study is a Clinical Profile and Management of Incisional
Hernia in a Rural Tertiary Care Hospital done at Kamineni Institute of Medical
Sciences, Narketpally, from October 2015 to September 2017.
Materials and Methods: Forty cases of incisional hernia which were admitted in
Kamineni Institute of Medical Sciences were studied. The statistical data and analysis of
the cases studied during this period are presented in this study.
Results: It is more common in females than in males with a ratio of 4.71:1. Incidence of
incisional hernia was highest in the age group ranging from 40- 60 years. Most of the
patients presented with swelling (82.5%) and swelling with pain (12.5%). Incisional
hernia was more common in patients with previous history of gynecological operations
(52.5%). The incisional hernia was more common in the infra-umbilical region (52.5%).
In majority of patients (95%) the incisional hernia occurred within 3 years of previous
operation. The size of the hernial defect less than 40sq.cms was found in 22 patients
(55%).33 patients (70%) underwent mesh repair (30 Onlay and 3 sublay repairs), which
had good outcome and minimal post operative complications whwn compared to
anatomical repair. Post-operative complications included wound infection in 5 patients
(12.5%) followed by seroma in 3 patients (7.5%) and no complications in 31 patients.
There was only one recurrence constituting for 2.5% of total forty cases reported, and
there was zero mortality in the study.
Conclusion: Wound infection following previous surgery was the most important risk
factor associated with incisional hernia. The other risk factors were obesity and COPD.
Polypropylene mesh repair is superior to anatomical repair as it has less recurrence.

Background:The purpose of the study is to determine the appropriate mode of managing paraumbilical hernias in terms of complications and recurrences.
Materials and Methods: In this clinical study, 50 patients with paraumbilical hernia were admitted and underwent surgery subsequently from October 2019 to September 2021. The patients were studied for, clinical features, treatment and postoperative complications. Cases were prepared for surgery after preoperative correction of anemia, hypertension, obesity, diabetes and local skin conditions. All patients underwent surgical procedure after following preoperative preparation.
Results: The present study shows that majority of the patients are in the age group of 40-60years, i.e., between 4th and 6th decades of life (52%). 2 patients are above 70 years. In this study, the patients were categorized into two groups based on the procedure performed in accordance to the size of the defect: Both anatomical and prosthetic mesh repair was performed across all defect sizes and the outcomes compared. Among 28 patients with a defect size of 2-5cms, anatomical repair was performed in 18 patients (64.2%), while mesh repair was performed in 10 patients(35.7%). Among 22 patients with a defect size more than 5cms, anatomical repair was performed in 6 patients (27.2%), while mesh repair was performed in 16 patients (72.7%). Skin necrosis, wound infection, seroma and wound dehiscence were noted in this study group. Skin necrosis was seen in 2 patients (8.3%) in anatomical repair group, while 1 patient (3.8%) developed in prosthetic mesh repair group. Wound infection was seen in 2 patients (8.3%) in anatomical repair group, while 3 patients(11.5%) developed in prosthetic mesh repair group.  Seroma was seen in 4 patients (16.6%) in anatomical repair group, while 2 patients(7.6%) developed in prosthetic mesh repair group. In two years of regular follow up, 2 recurrences (8.3%) were noted in the anatomical repair group while no recurrences were noted in the prosthetic mesh repair group. The subjects who underwent anatomical repair  were followed up for a mean period of 14.63 months with a standard deviation of 6.67 and those who underwent prosthetic mesh repair were followed up for a mean period of 13.45 months with a standard deviation of 5.8.
Conclusion: To conclude, it can be said that in the treatment of paraumbilical hernias, prosthetic mesh repair seems superior to anatomical repair, although significant difference could not be demonstrated. Statistical significance between the two procedures probably could be obtained if the sample size and follow up period is increased.