Incisional hernia after abdominal surgery in infants: A retrospective analysis of incidence and risk factors

Infographic · Feb 2022 · 1 min read

In brief

This 20-year retrospective study of 2,055 infants found a 5.2% incidence of incisional hernia after abdominal surgery, with highest rates in necrotizing enterocolitis, gastroschisis, and omphalocele patients. Wound infection, preterm birth, and prior stoma were significant risk factors, while 15% of hernias resolved without surgical intervention.

Incisional hernia occurs in 5.2% of infants after abdominal surgery—higher than previously reported rates.
Gastroschisis (19%), omphalocele (17%), and NEC (12%) carry the highest incisional hernia risk among infant conditions.
Wound infection increases IH risk 5-fold; preterm birth increases risk 4-fold in infants undergoing abdominal surgery.
15% of infant incisional hernias resolve spontaneously without surgical intervention.
Number of operations and surgical approach do not significantly influence incisional hernia development in infants.

Written by the GCMD Library team from the infographic.

The infographic uses a red and white color scheme with a left sidebar containing study metadata and icons. The center shows a gray silhouette of a child with a surgical incision marked on the abdomen. The right side displays four risk factors with icons and odds ratios, connected by a gray gradient arrow pointing to a circular diagram of intestinal herniation at the bottom. A horizontal bar shows the relationship between risk factors and the 5.2% incisional hernia rate, with 15% spontaneous resolution noted.

Purpose

Incisional hernia (IH) is a complication following abdominal surgery extensively studied in adults but less so in infants. This study aimed to identify the incidence, high risk diseases and risk factors of IH following abdominal surgery in infants.

Methods

Infants undergoing abdominal surgery before the age of three years in our tertiary centre between 1998 and 2018 were included. Patient demographics, peri‑operative details and the course during follow up were retrospectively extracted from patient records. Multivariate logistic regression was performed to identify risk factors.

Results

The incidence of incisional hernia was 5.2% (107/2055). Necrotizing enterocolitis (12%), gastroschisis (19%), and omphalocele (17%) had the highest incidences of IH. Wound infection (OR: 5.3, 95%-CI:2.9–9.5), preterm birth (OR: 4.2, 95%-CI:2.6–6.7) and history of stoma (OR 1.7, 95%-CI:1.1–2.8) were significant risk factors for IH. Whilst age at surgery, surgical approach and total number of operations did not significantly influence IH development. The IH resolved in 15% (16/107) without surgery.

Conclusion

One in twenty infants experiences IH following abdominal surgery, which is higher than previously described. Understanding the incidence of IH and associated risk factors will allow physicians to identify infants that may be at increased risk for IH and to possibly act pre-emptively.

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