Other commonly acknowledged risk factors such as hernia size did not correlate with recurrent hernia formation. Wound hematoma and seroma were often associated with the resultant wound infection but by themselves were not a significant factor. The size of ventral hernias has been established as a risk factor and clearly mesh repairs have reduced recurrence rates in these patients. The exact length and width of the defect necessitating mesh repair is, however, not fully worked out. Technical failures such as inadequate mesh size and missed hernias are obvious but mesh fixation remains a problem.
Further investigation is indicated for methods to avoid mesh fascia detachment.
Risk factors, as elucidated above, need to be avoided when possible. An evaluation of risk factors in the incisional hernia recurrence. Factors affecting recurrence following incisional herniorrhaphy. Surgery Scientific Principles and Practice. 2nd Ed, Lippincott-Raven, Philadelphia, pp 1215 5.