Abstract
Purpose
Incisional hernia (IH) is a common and serious complication of abdominal surgery, but risk factors and optimal preventive strategies are not yet fully defined. This study aimed to determine the prevalence, timing and risk factors for IH following abdominal surgery in a high-risk patient population.
Patients and Methods :
A retrospective review of 222 patients who underwent abdominal surgery was conducted in two hospitals in Yemen. The demographics of the patients, surgical variables and postoperative outcomes were analyzed. The prevalence and timing of IH were determined and univariate and multivariate analyzes were performed to identify risk factors for IH.
Results
The overall prevalence of IH was 19%, with 57% of cases occurring within 1 year after surgery (median 11 months). In the univariate analysis, significant risk factors for IH included ASA grade (p < 0.001), smoking (p = 0.044), diabetes (p = 0.003), hypertension (p = 0.044), malnutrition (p = 0.022), trauma (p < 0.001), peritonitis (p = 0.001), surgical site infection (SSI) (p = 0.015) and wound dehiscence (p < 0.001). In multivariate analysis, only postoperative wound dehiscence (odds ratio [OR] 9.874, 95% CI 3.317–29.389, p < 0.001) and poor nutritional status (OR 9.899, 95% CI 1.777–55.161, p = 0.009) emerged as independent risk factors for IH.
Conclusion
Our study found a higher prevalence of IH compared to some studies and identified several risk factors, including ASA, smoking, diabetes, hypertension, malnutrition, trauma, peritonitis, SSI and wound dehiscence. Wound dehiscence and poor nutritional status emerged as independent risk factors for the development of IH. Optimizing preoperative nutrition, managing postoperative infections, and preventing wound complications to reduce the risk of IH are crucial. More research is needed to explore the complex relationships between these factors and the occurrence of IH, ultimately leading to targeted interventions that can improve patient outcomes.