Gali B M, Madziga A G, Na'aya H U, Yawe T
Department of Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria.
Niger J Clin Pract. 2007 Sep;10(3):184-7.
Incisional hernias (IH) represent a breakdown or loss of continuity of a fascial closure. They are thus unique as the only external wall hernias that are iatrogenic in aetiology. Incisional hernias are not uncommon complications of laparotomy closure with reported incidence of 2 to 11%.
To review our experience,with incisional hernaia identify possible risk factors and proffer preventable strategies.
All case records of adult patients managed with IH at the University of Maiduguri Teaching Hospital between January 1995 and December 2004 were retrieved from the Medical Records Department. Relevant data on age, sex, type and institution of index surgery (General Hospital or Private Hospital), premorbid factors, type of repair, post-operative complications were extracted. Case records with inadequate information were excluded.
Between January 1995 and December 2004 a total of 440 patients with external abdominal hernias were treated at UMTH. Out of these: 38 (11.6%) were Incisional hernias and form the basis of this study. Their ages ranged between 18 and 80 years, with peak age range of 40-49 years. There were 6 males and 32 females giving a male to female ratio of 1:5.3. The commonest index surgeries were caesarean section in 12 patients (31.6%) and appendicectomy 10 patients (26.3%). Of the index surgeries 26 (68.4) and 10 (26.3) were performed in general and private hospitals respectively. Only 2(5.3%) were done at UMTH. Wound sepsis, in 18 patients (47.4%), postoperative cough, 8 (21.1%) and obesity 6 (15.8%) were the commonest risk factors. Poor surgical technique was found in 36 patients (94.7%) Most of the patients presented late; 8(21.1%) with recurrence and 6(15.8%) were giant in size. All but one were successfully repaired. Only one (2.3%) had recurrence. There was no mortality.
Incisional hernias are not uncommon constituting 11.6% of all adult external abdominal wall hernias repaired at UMTH. Most of the causes are preventable with 94.7% of the index surgery done at peripheral hospitals where poor surgical technique was common to all. There is urgent need to re-train our general duty doctors on proper surgical techniques of abdominal wound closure.
切口疝（IH）是指筋膜闭合处出现的连续性中断或丧失。因此，它们是独特的，因为它们是唯一病因医源性的腹壁外疝。切口疝是剖腹手术闭合常见的并发症，报道的发生率为2%至11%。
回顾我们治疗切口疝的经验，确定可能的危险因素并提出可预防的策略。
从迈杜古里大学教学医院病历科检索1995年1月至2004年12月期间接受切口疝治疗的所有成年患者的病例记录。提取有关年龄、性别、初次手术的类型和机构（综合医院或私立医院）、病前因素、修复类型、术后并发症的相关数据。排除信息不充分的病例记录。
1995年1月至2004年12月期间，迈杜古里大学教学医院共治疗了440例腹外疝患者。其中，38例（11.6%）为切口疝，构成了本研究的基础。他们的年龄在18岁至80岁之间，年龄峰值范围为40 - 49岁。男性6例，女性32例，男女比例为1:5.3。最常见的初次手术是剖宫产12例（31.6%）和阑尾切除术10例（26.3%）。初次手术中，26例（68.4%）和10例（26.3%）分别在综合医院和私立医院进行。只有2例（5.3%）在迈杜古里大学教学医院完成。伤口感染18例（47.4%）、术后咳嗽8例（21.1%）和肥胖6例（15.8%）是最常见的危险因素。36例（94.7%）存在手术技术欠佳的情况。大多数患者就诊较晚；8例（21.1%）复发，6例（15.8%）为巨大疝。除1例患者外，其余均成功修复。只有1例（2.
