Incisional hernias are a common postoperative complication following midline laparotomies, often contributing significantly to patient morbidity, impaired quality of life, increased healthcare costs, and in some cases, the need for complex reoperations. Despite advancements in surgical techniques and materials, the incidence of incisional hernias remains clinically significant. This prospective study was undertaken to evaluate the incidence, associated risk factors, time of onset, and effectiveness of various prevention strategies for incisional hernias following midline laparotomies. The study included patients undergoing elective and emergency midline laparotomies at three tertiary care centers: Santosh Medical College and Hospital, Ghaziabad; Saraswathi Institute of Medical Sciences; and SGPGI, Lucknow. A total of [Insert Number] patients were enrolled between [Insert Time Period], and followed up for a period of [Insert Follow-up Duration] postoperatively. Inclusion criteria consisted of patients above 18 years of age undergoing midline laparotomy with primary wound closure. Exclusion criteria included patients undergoing re-exploration within 30 days, patients with pre-existing hernias, or those lost to follow-up. Patient demographics, comorbid conditions such as diabetes, COPD, anemia, obesity (BMI >30), and hypoalbuminemia, along with intraoperative factors such as type of suture material used, wound closure technique, presence of postoperative wound infection, and duration of surgery were carefully documented. Preliminary findings suggest that the incidence of incisional hernias in our study cohort was approximately [Insert Percentage]%. The most common risk factors identified were postoperative wound infection, obesity, diabetes mellitus, prolonged operative time, and emergency surgeries. Hernias were observed to develop within a median period of [Insert Time] months, with the majority manifesting within the first postoperative year. Notably, the use of prophylactic mesh in selected high-risk patients and proper surgical technique including mass closure with non-absorbable sutures were associated with a lower incidence of hernias. The study emphasizes the importance of comprehensive risk assessment preoperatively, meticulous surgical technique, and vigilant postoperative wound care as key strategies in the prevention of incisional hernias. Early identification and modification of modifiable risk factors can significantly reduce the overall incidence. This study contributes valuable data to the ongoing discourse on the management and prevention of incisional hernias, particularly in resource-constrained settings where such complications can have significant socioeconomic impacts. Further long-term studies with larger sample sizes are warranted to validate these findings and guide the development of standardized preventive protocols.

Incisional hernia, Midline laparotomy, Risk factors, Wound infection, Surgical complications, Hernia prevention