An incisional hernia is the protrusion of abdominal organs through a weakened area in the abdominal wall at the incision site of a previous abdominal surgery with a well-healed skin wound.
Herniation is more likely in vertical incisions than in horizontal (transverse) incisions.
Predisposing factors include: Intense coughing, straining due to constipation, pregnancy, obesity, vomiting, or physical activity involving the abdomen.
Diseases such as syphilis, diabetes, tuberculosis, and cancer, may also predispose an individual to incisional hernia following surgery. The material used to close the incision can also contribute to incisional hernia, as may poor wound closure technique.
An incisional hernia differs from a surgical wound dehiscence; in an incisional hernia, the skin is healthy and has healed but in surgical wound dehiscence the incision site becomes infected, which may lead to to accumulation of fluid (oedema) and softening of the tissues held together by the stitches (sutures). As a result, the tissue weakens, and the sutures cut through the tissue, including the skin. The wound eventually reopens (dehiscence), allowing the abdominal organs to bulge through the incision site.