Wound dehiscence and incisional hernia

The prevention and treatment of wound dehiscence and incisional hernia is a constant challenge to surgeons and other specialists operating in the abdomen. This paper discusses the risk factors and proposed mechanisms of pathophysiology of wound dehiscence and incisional hernia, followed by a discussion of the evidence regarding the best surgical technique of incision and closure of the abdomen in open surgery with focus on prevention of dehiscence and hernia. Lastly, the principles of management when faced with wound dehiscence and incisional hernia are addressed along with the treatment algorithm used at our institution. The focus of this paper is on median incisions and ventral median incisional hernia repair, being most common and extensively studied in the literature.