European hernia society (EHS) classification | 2009:
Morphologically: Midline (M1–5) and lateral (L1–4, right or left) hernias
Location of midline hernias: Zones M1 to M5, based on the proximity of the hernia to the xiphoid process, umbilicus or symphysis pubis; a hernial orifice can extend over several areas, e.g. M1 to 3 or M3 to 5
Location of lateral hernias: Zones L1 to L4 and labelled according their side.
For the purpose of standardization, hernias are to be classified intraoperatively.
The size of the hernial orifice is measured in “length” and “width“. Since width is of particular prognostic relevance, the size of the hernial orifice is categorized according to width (W) in W1 (<4 cm), W2 (4–10 cm) or W3 (>10 cm).
Incisional hernias can occur after any abdominal surgical procedure where the abdominal wall is incised.
Incisional hernias develop because of the failure of the abdominal wall to close properly. Despite advancements in techniques for abdominal wall closure the incisional hernia rate following laparotomy is as high 15% to 20%.
Impair proper wound healing and affect the strength of the new tissue to support the abdominal wall increase the incidence of incisional hernia.
Systemic long-term medications: Steroids and immunosuppressants
Related to the surgical technique or suture materials used for closure. Incision site, timing, and urgency of procedure, complications, and underlying diseases are associated with a higher incidence of incisional hernia development.
Emergency surgeries, midline incisions, infection, and acute abdominal surgeries