Incisional Hernias: Risk Factors and Treatment in a Context of Limited Resources

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Résumé

Background: The purpose of this study was to describe the etiologic factors
and therapeutic modalities of incisional hernias in the department of surgery
at the regional hospital of Tenkodogo, in Burkina Faso. Methods: It is a cross
sectional study covering the period from 2010 to 2012. Sampling was com
prehensive, including all the patients operated for incisional hernias during
this period. Results: Fifty-four patients were included. Their average age
was 22.3 years. There were 35 (64.8%) males and 19 (35.2%) female patients.
We counted 28 large-size incisional hernias, 14 medium-size incisional hernias
and 12 incisional hernias of small size. The average time from the first surgery
to the diagnosis of incisional hernias was 8 months. Generalized acute peritonitis
(44.4%) and acute intestinal obstructions (22.2%) were the main indications
of initial surgical interventions. Vertical midline incisions have been involved
in 37 cases (68.5%). Therapeutically, two surgical techniques have been used:
open suture repair and open mesh repair. Forty-two patients (77.8%) were
treated by open suture repair. Twelve patients (22.2%) benefited from open mesh
repair. Post-operative complications were noted in 2 patients. Nine patients (16.7%)
presented a recurrence after 12 months. Conclusion: In the rural area of Bur
kina Faso, incisional hernias occur in young patients. Emergencies with abdo
minal Infections are the main operative indications. Prostheses are relatively
high cost and less accessible. The recidivism rate is high.

Mots-clés

Keywords Incisional Hernia, Abdominal Wall Closure, Surgical Treatment, Burkina