aetiology
Last reviewed 10/2020
Predisposing factors to incisional herniae may occur singly or together. These include:
- poor surgical technique - inadequate fascial bites, tension on the fascial edges, or too tight a closure
- post-operative wound infection
- age - healing is slower in older patients
- general debility - cirrhosis, carcinoma, and chronic wasting diseases affect wound healing
- obesity - fat patients have a raised intra-abdominal pressure
- type of incision used - many surgeons believe that transverse and oblique wounds heal better than vertical ones
- post-operative pulmonary complications that stress the repair as a result of vigorous coughing. Smokers and patients with chronic pulmonary disease have the greatest risk.
- placement of drains or stomas in the primary operative wound
- failure to use non-absorbable suture material
- failure to pay proper attention to protein nutrition and vitamin C
- catabolism due to sepsis slows wound healing
- steroid use
- diabetes mellitus
- collagen disorders