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Aetiology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

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