Notes Concerning Current Pathophysiological Aspects of Incisional Hernia

  • Aldo Bove
  • Laura Corradetti
  • Luciano Corbellini
Part of the Updates in Surgery book series (UPDATESSURG)


Wound healing requires an initial haemostatic phase, an inflammatory phase lasting from minutes to hours, the migration of resident cells (fibroblasts, epidermal cells and endothelial cells) within the following 24 h and a regenerative phase during the subsequent 3 days. During the latter phase, activated fibroblasts respond to the growth factors present and initially produce type III collagen[1]. Contemporaneously, angiogenesis begins with the organisation of the collagen fibres; at this point, type I collagen and the phagocytes that remove fibrin come into play [2].


Chronic Obstructive Pulmonary Disease Inguinal Hernia Incisional Hernia Abdominal Aortic Aneurysm Osteogenesis Imperfecta 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    McPherson JM, Piez KA (1988) Collagen in dermal wound repair. In: Clark RAF, Henson PM (eds) The molecular and cellular biology of wound repair. Plenum press, New York, pp 471–496Google Scholar
  2. 2.
    Gay S, Viljanto J, Raekallio J, Pentinnen R (1978) Collagen types in early phases of wound healing in children. Acta Chir Scand 144:205–211PubMedGoogle Scholar
  3. 3.
    Wagh PV, Leverich AP, Sun CN et al (1974) Direct inguinal herniation in men: a disease of collagen. J Surg Res 17(6): 425–433PubMedCrossRefGoogle Scholar
  4. 4.
    Tilstra DJ, Beyers PD (1994) Molecular basis of hereditary disorders of connective tissue. Annu Rev Med 45:149–163PubMedCrossRefGoogle Scholar
  5. 5.
    Yoshino T, Sumiyoshi H, Shin T et al (2005) Multiple proteins are involved in the protein-DNA complex in the proximal promoter of the human alpha1(III) collagen gene (COL3A1). Biochim Biophys Acta 1729(2):94–104PubMedGoogle Scholar
  6. 6.
    Mc Vay CB, Read RC, Ravitch MM (1967) Inguinal hernia. Curr Probl Surg 10:28–29Google Scholar
  7. 7.
    Rosch R, Lynen-Jansen P, Junge K et al (2006) Biomaterial-dependent MMP-2 expression in fibroblasts from patients with recurrent incisional hernias. Hernia 10:125–130PubMedCrossRefGoogle Scholar
  8. 8.
    Janoff A (1985) Elastases and enphysema. Current assessment of the protease-antiprotease hypothesis. Am Rev Respir Dis 132(2):417–433PubMedGoogle Scholar
  9. 9.
    Adye B, Luna G (1998) Incidence of abdominal wall hernia in aortic surgery. Am J Surg 175:400–402PubMedGoogle Scholar
  10. 10.
    Drouilhet J, West B (1999) Incisional hernia following aortic surgery. Hernia 3:135–140CrossRefGoogle Scholar
  11. 11.
    Sorensen LT, Hemmingsen U, Kallehave F et al (2005) Risk factors for tissue and wound complications in gastrointestinal surgery. Ann Surg 241(4):654–658PubMedCrossRefGoogle Scholar
  12. 12.
    Lindholt JS, Jorgensen B, Klitgaard NA, Henneberg EW (2003) Systemic levels of cotinine and elastase, but not pulmonary function, are associated with the progression of small abdominal aortic aneurysm. Eur J Vasc Endovasc Surg 26(4):418–422PubMedCrossRefGoogle Scholar
  13. 13.
    van Laarhoven CJ, Borstlap AC, Berge Henegouwen DP et al (1993) Chronic obstructive pulmonary disease and abdominal aortic aneurysm. Eur J Vasc Surg 7(4):386–390PubMedCrossRefGoogle Scholar
  14. 14.
    Cannon DJ, Read RC (1981) Metastatic emphysema: a mechanism for acquiring inguinal herniation. Ann Surg 194(3):270–278PubMedCrossRefGoogle Scholar
  15. 15.
    Friedman D, Boyd C, Norton P et al (1993) Increases in type III collagen gene expression and protein synthesis in patients with inguinal hernias. Ann Surg 18:754–760CrossRefGoogle Scholar
  16. 16.
    Si Z, Bhardwaj R, Rosch R et al (2002) Impaired balance of type I and type III procollagen mRNA in cultured fibroblasts of patients with incisional hernia. Surgery 131(3):324–331PubMedCrossRefGoogle Scholar
  17. 17.
    Michael G, Franz (2006) The biology of hernias and the abdominal wall. Hernia 10:462–471CrossRefGoogle Scholar
  18. 18.
    Rives J, Lerdennois B, Pire JC (1974) Physiopathologie des éventration. 75ème Congres Francais de Chirurgie, Actualites Chirurgicales. Masson, ParisGoogle Scholar
  19. 19.
    Ellis H, Gajraj H, George CD (1983) Incisional hernias: when they occur? Br J Surg 70:290–291PubMedCrossRefGoogle Scholar
  20. 20.
    Klinge U, Prescher A, Klosterhalfen B et al (1997) Development and pathophysiology of abdominal wall defects. Chirurg 68:304–309CrossRefGoogle Scholar
  21. 21.
    Sugerman HJ, Kellum JM Jr, Reines HD et al (1996) Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg 171:80–84PubMedCrossRefGoogle Scholar
  22. 22.
    Klinge U, Binnebosel M, Mertens PR (2006) Are collagens the culprits in the development of incisional and inguinal hernia desease? Hernia 10:472–477PubMedCrossRefGoogle Scholar
  23. 23.
    Heggers JP (1991) Variations on a theme. In: Heggers JP, Robson MC (eds) Quantitative bacteriology: its role in the armamentarium of the surgeon. CRC Press, Boca Raton, pp 15–23Google Scholar
  24. 24.
    Carrico TJ, Mehrhof AI, Cohen IK (1984) Biology of wound healing. Surg Clin North Am 64(4):721–733PubMedGoogle Scholar
  25. 25.
    Knuutinen A, Kokkonen N, Risteli J et al (2002) Smoking affects collagen synthesis and extracellular matrix turnover in human skin Br J Dermatol 146(4):588–594PubMedCrossRefGoogle Scholar
  26. 26.
    Goodson WH III, Radolf J, Hunt TK (1980) Wound healing and diabets. Appleton-Century-Crofts, New York, pp 106–117Google Scholar
  27. 27.
    Williamson JR, Chang K, Rowold E et al (1986) Diabetes induced increases in vascular permeability and changes in granulation tissue levels sorbitol, Myo-inositol, chiroinositol are prevented by sorbinil. Metabolism 35:41–45PubMedCrossRefGoogle Scholar
  28. 28.
    Sorensen LT (2006) Effect of lifestyle, gender and age on collagen formation and degradation. Hernia 10:456–461PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • Aldo Bove
  • Laura Corradetti
  • Luciano Corbellini

There are no affiliations available

Personalised recommendations