Incidence and aetiological factors of incisional hernia in post-caesarean operations in a Nigerian hospital.

Caesarean operations accounted for most of the postoperative incisional hernias seen in our surgical clinic. In order to determine the incidence and aetiological factors of incisional hernia, all the women who had caesarean operations were reviewed retrospectively. There were 22 cases of incisional hernia, accounting for 3.1% of total 701 patients who had caesarean sections during the period of the study. The incidence of incisional hernia was influenced by the type of incision, as all those who developed incisional hernia had a midline incision, the need for additional operative procedures and antibiotic administration longer than usual with more potent antibiotics. Presence of postoperative abdominal distention, intra-abdominal sepsis, residual intra-abdominal abscess, wound infection and wound dehiscence and postoperative fever also contributed significantly to the incidence of incisional hernia. Those who developed incisional hernias also suffered other postoperative complications and stayed longer in the hospital after the operation. The age of the patients, the parity and indication for caesarean section did not influence the incidence of incisional hernia in this study.