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. 2017 Nov 3;2017(11):CD005661. doi: 10.1002/14651858.CD005661.pub2

1. Factors associated with incisional hernia.

In surgeon's control Other factors
Type of incision
  • Midline

  • Paramedian

  • Pfannenstiel

  • Maylard, etc

Postoperative inflammatory response to sutures, which may be suture‐specific. For example, studies have shown that synthetic absorbable materials tend to induce lower levels of inflammation compared to catgut (Nilsson 1983; Postlethwait 1975)
Incision technique
  • 2 scalpel (1 for skin and 1 for deeper tissue) versus single scalpel

  • Single stroked versus multiple stroked incision

  • Scalpel versus cautery using cutting current versus cautery using coagulation current versus carbon dioxide laser

Associated co‐morbid conditions
  • Advanced age of the patient

  • Nutritional status of the patient

  • Severe obesity

  • Diabetes

  • Malignancy

  • Jaundice

  • Abdominal distension

  • Chronic steroid therapy

  • Wound infections in the primary laparotomy

  • Smoking

  • Chronic obstructive pulmonary disease

Preoperative surgical preparation of incision site and pre‐operative antibiotics Nature of wound
  • Clean

  • Clean‐contaminated

  • Contaminated

Use of subcutaneous drains Neoadjuvant therapies
  • Chemotherapy

  • Radiation

  • Immunotherapy

Suture material
  • Absorbable versus non‐absorbable suture material

  • Monofilament versus multifilament suture material

 
Suture technique
  • Mass versus layered closure

  • Continuous versus interrupted sutures

  • Suture length: wound length ratio