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Incisional Hernia

An incisional hernia is a type of hernia that involves the incompletely healing of a surgical wound. For the most part, a surgical wound depends on the natural healing process to seal itself. However, a surgical wound may defy healing if an infection develops and/or it becomes a weakened surgical scar. A partial segment of an organ, tissue, or muscle may protrude through active surgical openings and/or put pressure under surgical scars. Once this protrusion occurs, a patient may likely experience symptoms such as pain, pressure, swelling, and/or a fever.

Causes

Causes of an incisional hernia are infection, poor wound care, improper surgical techniques and/or stitching, and other complications that compromise a surgical wound and/or manipulate a past surgical wound. Risk factors of an incisional hernia are obesity, pregnancy, excessive pressure from coughing, sneezing, and having a bowel movement, heavy lifting, and/or overexertion that can force internal organs, tissues, and/or muscles to protrude through a surgical wound or place internal pressure underneath a weakened surgical scar. Additionally, risk factors such as smoking, chemical exposure, poor diet, drinking alcohol, and high stress can cause conditions that require surgery.

The most common risk factors of an incisional hernia follow below:

  • Poor wound care

  • Infection

  • Overexertion

  • Poor lifting techniques

  • Internal pressure from hard coughing or straining

  • Improper surgical techniques or stitching

  • Obesity

  • Pregnancy

Symptoms

Symptoms of an incisional hernia include pain, pressure, swelling, and fever. Signs of this type of hernia are found during the examination process, such as bulging near the surgical scar, visible protrusion of internal tissue, organ, intestine, muscle, and/or fatty contents, and bleeding. The most common hernias exhibit symptoms and signs that resemble each other. Fortunately, these common types of symptoms and signs of hernias can help doctors to detect an incisional hernia due to this hernia resulting from a complication of surgery.

The following symptoms and signs of an incisional hernia include:

  • Fever

  • Infection

  • Bulging (palpable lump and/or mass on surgical scar)

  • Visible protrusion

  • Pain

  • Aching

  • Swelling

  • Foul-smelling drainage

  • Redness and/or red streaks (sign of infection)

  • Bowel obstruction (strangulation of intestines)

  • Symptoms related to compromised organ (digestive disorders and jaundice due to protrusion of liver)

The following screening and tests are used to diagnose an incisional hernia:

  • Palpating a surgical wound or surgical scar to locate a bulge, swelling, and/or protrusion.

  • Blood tests

  • X-ray

  • CT scan

Treatments

Treatments for an incisional hernia require surgical intervention. For the most part, this hernia will not heal on its own without surgery. Patients must understand the severity of an untreated incisional hernia to avoid more serious complications such as strangulation of the intestine, which can lead to tissue death of this important internal membrane.

The following two types of surgeries are recommended treatment options to repair an incisional hernia:

Open hernia repair – most common surgical technique involves making a skin incision over the affected site to make a hernia repair.

Laparoscopic hernia repair – A less invasive surgery that uses a small tube with a camera to repair the hernia. This surgical device is inserted into small incisions of the abdomen, where the surgeon can watch this procedure on a monitor.