IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 20, Issue 2 Ser.5 (February. 2021), PP 28-31 www.iosrjournals.org DOI: 10.9790/0853-2002052831 www.iosrjournal.org 28 | Page A Prospective Study of Clinical Profile and Management of Incisional Hernia in a Tertiary Care Hospital Dr.Sanjay Kumar 1 , Dr.K.K.Singh 2* 1 Assistant Professor, Department of Surgery, Medinirai Medical College, Medininagar, Palamu, Jharkhand. 2* Associate Professor, Department of Surgery, Medinirai Medical College, Medininagar, Palamu, Jharkhand, India. Corresponding Author: Dr.K.K.Singh Abstract Introduction: Incisional hernias (IH) are among the most common abdominal surgery complications. The overall estimated incidence of IH ranges from 2 to 11%and 80–95% develop it within six months to 3 years after surgery. An 8 to 29% of the IH are asymptomatic and remain undetected if the patient is not examined. Wound infection, suture closure technique and obesity are the most critical risk factors for the development of IH. Materials and Methods: This was a prospective study done at our hospital between January 2017 and December 2020. A total number of 98 cases were included in this study. Detailed history was recorded and thorough clinical examination done. The patients were investigated for routine blood examination, ultrasonography and radiology. The patients were followed up for immediate and delayed postoperative complications. The information thus obtained was, tabulated, and analyzed. Results: The age distribution of the total cases of incisional hernia ranged from 29years to 70 years and had a maximum number of patients in the 31 to 40yrs age group (48%); 82% of patients were less than 55 years of age. We had 82 female patients and 16 male patients, female to male ratio was about5:1. Conclusion: Incisional hernia is more common in females after abdominal surgery. It mostly affects the age group 30-40 years. Most patients were housewives and sedentary workers. It usually appears within two years of the abdominal surgery. The commonest surgeries complicated with IH in our study were, gynecological operations and emergency laparotomies through Infra-umbilical midline incision. Other factors were post- operative wound infection, peritoneal contamination, obesity, multiparity, chronic cough, and constipation. The presenting complain is intermittent swelling and/or pain at the incisional line. Polypropylene mesh repair was found to give the best result with almost negligible recurrence. Key Words: Incisional hernia, Polypropylene mesh repair, ultrasound, chest x-ray. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 29-01-2021 Date of Acceptance: 14-02-2021 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Incisional hernias (IH) are among the most common abdominal surgery complications. The overall estimated incidence of IH ranges from 2 to 11% and 80–95% develop it within six months to 3 years after surgery. An 8 to 29% of the IH are asymptomatic and remain unaccounted for if the patient is not examined. Wound infection, suture closure technique and obesity are the most critical risk factors for the development of IH. 2 An incisional hernia is a late complication following abdominal surgery, occurring as a result of dehiscence of fascial closure and, also, an iatrogenic disease. 3 The incidence after laparotomy has been reported as ranging between 4% and 12%, but the actual incidence is underestimated. 4 Many incisional hernias are asymptomatic, but if symptoms are present, an incisional hernia may be associated with morbidity, reduced work time for those who are employed, and low quality of life. Given the high cost for incisional hernia repair and the disappointing recurrence rates of up to 45%, incisional hernia remains a significant challenge for most surgeons. 5 The main objective of this study was to analyze the etiopathogenesis of incisional hernia, to determine the patient’s variable factors, and operative dependent variables conditions. At the same time to ascertain various modes of presentation and different therapeutic modalities. Aspects in prevention of this dreaded complication of abdominal surgeries were also determined.