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Incisional Hernias - Causes

Incisional hernias are caused due to stretching of scar tissue that forms after surgery and occurs due to constant pressure of abdominal contents on the scar.

Not all abdominal surgeries will lead to incisional hernia, but any full thickness abdominal incision can leave a weakness and make that area prone to hernia. Usually a proper closure and adequate post-operative measure avoids the problem. However, sometimes despite the best care, a person may develop the hernia and at other times it can be predicted depending on the patient’s general condition and the type of surgery performed.


Normally there are three layers covering the abdominal contents. These include a thin inner sheet called the peritoneum, a thick middle layer of muscles and the third outer layer – the outer skin. An incisional hernia forms usually due to weakness of the thick layers of muscles. There are various factors that can lead to the weakness or hernia formation and these factors generally can be broadly looked at as –

Mechanical factors

Patient-related factors

Or Technical factors

Mechanical factors

Mechanical factors increase the intra-abdominal pressure after an operation and causes the hernia. Common causes include-

Chronic cough- Coughing and vomiting are associated with a brief but significant increase in intra-abdominal pressure. This, again, leads to too much tension on the incision and possible breakdown of the incision.

Lifting heavy weights- Obviously, if a patient lifts something too heavy immediately after the operation, he or she can also tear the incision and cause a hernia.

Postoperative ileus- This occurs when the abdomen becomes distended because the intestines are not working properly after an operation. The swelling of the intestines increases the pressure in the abdomen and places tension on the incision. The tension then leads to defective healing.

Straining to move bowels after surgery– Constipation is another culprit for hernia formation. During the post-operative period and for a few months afterwards one should avoid straining while moving the bowels.

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murugu123 

i am 54 years lady at present i have an incisional Hernia, 4 years back i had undergone operation uterus removing whether immediate surgery is required but i don't have any pain

Sarahsue 

10 days Post op from ingiunal repair recurrence and femoral hernia repair (same side). Cement Twinkie at the surgery site. Anyone? I am a 42 y/o female.

Marc_Twain 

My 73 yr old mother needs umbilical hernia repair. Skeptical about medical procedures, she is put it off til it is bigger. Does not like idea of Biologic implants. What is safest mesh material to use? Or, in general, which mesh material has the least complications / lawsuits ? Polypropylene, polyester,...what ? Thank you for any anticipated answer.

Squeeker 

I am scheduled to have a rather large Incisional Hernia repaired, because it is such a large hernia my surgeon has recommended using MESH. I have heard a lot of negative things regarding MESH and do not know which Mesh would be the safest to use. Do you have some suggestions on which MESH would be best?
I did express my concerns to my surgeon but there was no recommendation. Also I was told that if you could have a Cosmetic Surgeon join in with your Surgeon you may have much better results. Is this true?

akab66 

Hi also had umbilical hernia repair surgery 2 months ago and am experiencing burning sensation and pain around the incision. I am passing gas frequently and feel tired often. Have had issues with bloating and pain in the upper part of my stomach for some time and have been told there may be some adhesions. Its just a pity the Doctors do not tell you much about the recovery process and they make you think the surgery is just a simple procedure.

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