with more elderly people undergoing surgery [1,2] and the increasing application of more complex procedures serve to maintain the prevalence of incisional hernias. About 10 to 30% of all patients undergoing laparotomy develop an incisional hernia [3][4][5][6]. Despite results of a prospective, controlled, randomised blind study showing the computed likelihood of incisional hernia at one year of 1.5% in the prophylactic mesh group compared to 35.9% in the group without mesh closure [7]; only few surgeons take prophylactic measures such as use of mesh for closure of wounds at high risk in order to prevent incisional hernias. The direct hospital costs and indirect costs to society of using mesh relative to primary suture closure after elective laparotomy showed mesh to be more effective, less costly and overall more cost-effective [8]. Incisional hernias therefore remain a major issue for patients undergoing abdominal surgery. It is not surprising therefore that there is ongoing debate about whether repair of incisional hernias should remain in the purview of general surgeons or be handed over to specialist hernia surgeons.The aim of this study was to review the experience of incisional hernias at a tertiary institution to determine what factors might improve the outcome of care. MethodsAll patients with incisional hernias operated at Derriford Hospital, Plymouth between January 2009 and December 2011 were included in the study. A retrospective review was performed to include elective and emergency cases; operative details of the index procedure and hernia repair; and postoperative events including wound events; surgical site infections (SSI) and outcome. To achieve this, a comprehensive review of Abstract Background and aims: About 10-30% of patients undergoing laparotomy develop an incisional hernia. The aim of this study was to review the experience of incisional hernias at a tertiary institution to determine what factors might improve the outcome of care.

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