Certain risk factors can identify a patient who may have a recurrent incisional hernia following an initial repair. The authors are from the University of Texas Southwestern Medical School and Veterans Affairs Health Care System in Dallas.


The most important risk factor was:

(1) obesity (BMI >= 28, body weight > 120% of ideal body weight).


Other factors increasing the risk of recurrent incisional hernia after an initial repair:

(2) large defect

(3) post-operative surgical site infection

(4) use of fascial reapproximation rather than use of prosthetic material/mesh


Dr Toouli in the Commentary added:

(5) failure to use nonabsorbable suture material


Additional factors:

(6) disorders of collagen formation

(7) chronic steroid use


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