Patient Awareness and Symptoms From an Incisional Hernia

Abstract

Incisional hernia is a common postoperative complication following open abdominal surgery with incidence varying between 3% and 20%.1 Approximately half of all incisional hernias are diagnosed within 1 year following surgery. In the United Kingdom alone, about 10,000 incisional hernia repairs are performed annually. Incisional hernia repairs are generally elective with emergency repair due to incarceration or strangulation constituting about 15% of repairs.1 Incisional hernia repair is not a low-risk operation and generally has relatively poor results due to chronic postoperative pain and high recurrence rates.2−3 Little has been published on patients' awareness of incisional hernia following open abdominal surgery. Moreover, there are very few publications on indications for incisional hernia repair and on the natural course of such hernias. The literature suggests that symptoms and complaints usually presented by patients include pain, discomfort, cosmetic complaints, skin problems, incarceration, strangulation, functional disability, and pulmonary dysfunction.4−6 The aim of this study was to investigate whether patients were aware that they had a hernia. In addition, we sought to determine symptoms for those who knew that they had an incisional hernia.

Ventral Hernia Management

“…[44][45][46][47][48][49][50] Whereas these are all small studies, they suggest that nonoperative management is an acceptable option for patients with umbilical, incisional, and parastomal hernias. [44][45][46][47][48][49][50] Whereas these are all small studies, they suggest that nonoperative management is an acceptable option for patients with umbilical, incisional, and parastomal hernias.…”

Development and Validation of a Risk Stratification Score for Ventral Incisional Hernia after Abdominal Surgery: Hernia Expectation Rates in Intra-Abdominal Surgery (The HERNIA Project)

“…4 Even patient reported results are inaccurate with up to 1/3 of patients unaware that they have a VIH. 3 Consensus is needed to identify a clinically relevant and standardized method of reporting the presence and absence of a ventral hernia. Third, follow-up duration was variable and some patients had limited follow-up.…”

“…VIHs cause significant morbidity for patients: they can increase in size, worsen an individual's ability to function, cause skin breakdown, or incarcerate and strangulate requiring emergency surgery. 2,3 While outcomes of emergency VIH repair are poor, elective repair can be complex and associated with high rates of complications including surgical site infections (SSI: 20-30%) and hernia recurrences (20-30%). 4,5 It is estimated that the United States spends 3.2 billion dollars annually on the surgical management of ventral hernias.…”

Use of Computed Tomography in Diagnosing Ventral Hernia Recurrence

“…[24][25][26] Given that the risk for incarceration or strangulation of clinically detectable hernias is low (estimated 1%-2% per year; range, 0%-20%), one might postulate that the risk for complications from radiologically detected hernias would also be low. [27][28][29][30][31][32] Repair of hernias only detectable on radiologic imaging may result in the unnecessary use of resources, increased risk for complications, and increased stress on patients. 33 In addition, without the correlation of intraoperative findings, it is unclear whether these hernias only seen on imaging are actually present.…”