Background: Incisional hernia is one of the most common complications in abdominal surgery. The aim of this retrospective study was to examine the true incidence of incisional hernia and its risk factors in patients undergoing surgery for colorectal cancer.
Patients and method: Two hundred ninety-five patients who underwent colorectal cancer surgery between 1993 and 2003 were included. The mean follow-up was 37.5 +/- 22 months.
Results: Forty-three patients developed incisional hernia, representing 14.5% of the total. The cumulative percentage of patients developing incisional hernia was 7% at 6 months, 16% at 1 year, 21% at 2 years and 33% at 5 and 10 years. The only significant independent risk factors were chronic obstructive pulmonary disease (COPD) (2-year cumulative incidence of incisional hernia of 53%, p = 0.04) and abdominal wound infection (2-year cumulative incidence of incisional hernia of 28%; p = 0.02).
Conclusion: COPD and abdominal wound infection predispose to incisional hernia in colorectal surgery. Abdominal wound infection is the only factor over which the surgeon can act preventively by using antibiotic prophylaxis and an aseptic technique.