Incisional hernias: incidence following abdominal aortic aneurysm repair.

It is thought there is an increased incidence of incisional herniation after the repair of an abdominal aortic aneurysm. We sought to assess this premise by reviewing 281 patients who had undergone abdominal aortic aneurysm repair over the preceding eight years at Concord Hospital. Incisional hernias were found in fourteen patients. This made up 5% of the total group having surgery (281 patients) or 6% of those surviving 12 months or more after operation (231 patients). Of these 231 patients, seven had transverse incision hernias (6.7% of all those with transverse incisions), and seven had vertical incision hernias (5.4% of all those with vertical incisions). Six of the fourteen patients with a hernia had needed an urgent repair of an abdominal aortic aneurysm. We conclude from this study, that there is no evidence of an increased incidence of incisional hernias associated with aneurysmal disease itself. Rather, the factors causing such hernias are common to all laparotomies for major disease in sick, elderly patients, in the absence of intra-abdominal sepsis.