Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content ++ Incarceration.Strangulation.Bowel obstruction.Functional or cosmetic deformity.Threatened overlying skin.Pain. +++ Absolute ++ Inability to tolerate general anesthetic (cardiopulmonary risk).Absence of tissue for reconstruction (myofascia or skin).Massive loss of peritoneal domain. +++ Relative ++ Infection.Moderate loss of peritoneal domain.Morbid obesity.Malnutrition.Tobacco use.Bleeding diathesis.Ascites. ++ The patient should be supine for the most common midline incisional hernias.Modified decubitus positions are used for flank incisional hernia repairs, with appropriate pressure points padded.Limited hip flexion can help relax the abdominal wall musculature.Tilting the head of the operating table up or down, left or right, aids in gravity-assisted retraction of the abdominal viscera and reduction of the hernia sac contents. ++ Bowel rest until ileus resolves.Drains to prevent seroma formation if large flaps are raised.Binder for comfort (except after the components separation technique, in which compression may compromise blood flow to the abdominal wall skin flaps). ++ Recurrence. Early (within 1 month): usually related to technical issues.Late (after 1 year): most often due to patient factors leading to wound healing problems. The best clinical and preclinical evidence now supports the idea that the majority of incisional hernias are the result of very early laparotomy defects.Mesh (wound) infection or mesh extrusion.Bowel or bladder injury.Hematoma and seroma.Pain. GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessAnesthesiology 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessAnesthesiology Full Site: One-Year Individual Subscription $995 USD Buy Now View All Subscription Options