Symptoms of incisional hernias include a visible bulge or swelling under a previous surgical scar, discomfort or pain exacerbated by physical activity, changes in bowel habits like constipation, and in severe cases, symptoms of bowel obstruction such as nausea, vomiting, and intense abdominal pain. Early recognition and medical evaluation are essential to prevent complications.

Clinical findings of incisional hernias in Sub-Saharan Africa include a palpable bulge or swelling at the site of a previous surgical scar, often associated with discomfort exacerbated by physical activity. The hernia may alter the appearance of the scar, appearing stretched or widened. Depending on its reducibility, the hernia may be manually pushed back into place or could be irreducible, potentially leading to complications such as incarceration or strangulation. Timely clinical assessment and imaging are essential for diagnosis, followed by surgical intervention to repair the hernia and prevent further complications, considering the region's healthcare challenges and resource limitations.

Accurate clinical examination and sometimes imaging, such as ultrasound, are necessary to differentiate these conditions from incisional hernias and guide appropriate management in Sub-Saharan Africa, where access to healthcare resources may be limited.

1. Surgical Scar Tissue: Thickened or scarred tissue at the site of previous surgery can sometimes resemble a hernia but lacks the characteristic protrusion of abdominal contents.
2. Hematoma: Blood collection or localized swelling within the surgical scar can present as a bulge, especially in the early post-operative period.
3. Suture Granuloma: Inflammatory reaction to surgical sutures can lead to the formation of a firm, tender lump near the scar, which may mimic a hernia.
4. Seroma: Accumulation of fluid under the skin at the surgical site can create a swelling that resembles a hernia but is typically softer and fluctuant.
5. Lipoma: A benign fatty tumour under the skin may occasionally present as a palpable mass near a surgical scar, especially if the scar is in a subcutaneous location.

Investigating incisional hernias in Sub-Saharan Africa involves clinical examination to detect palpable bulges or swelling at surgical scars, supported by ultrasound imaging for initial diagnosis and assessment of complications like bowel obstruction. Clinical judgment and available resources guide further management, often requiring referral to surgical specialists for definitive treatment. Adaptation to local healthcare settings ensures timely diagnosis and appropriate intervention despite challenges in resource availability.

Treatment of incisional hernias in Sub-Saharan Africa primarily involves surgical repair or sometimes with mesh, typically performed through open techniques due to lower costs and accessibility compared to laparoscopic methods. Emergency surgery is necessary for incarcerated or strangulated hernias to prevent severe complications. Post-operative care focuses on wound management, pain control, and monitoring for complications such as infection or recurrence. Community health workers play a vital role in patient education and follow-up, facilitating adherence to post-operative care instructions. Capacity building through training local healthcare providers enhances the region's ability to manage and treat incisional hernias effectively despite healthcare resource challenges.

Follow-up of incisional hernias in Sub-Saharan Africa involves regular post-operative visits to monitor wound healing, assess for recurrence, and manage complications. Patient education on recognizing signs of complications and adhering to post-operative care instructions is crucial. Community health workers play a vital role in conducting home visits and supporting follow-up in remote areas. Long-term surveillance and capacity building among healthcare providers aim to ensure ongoing management and improve outcomes despite resource challenges in the region.

Prevention and control of incisional hernias in Sub-Saharan Africa involve ensuring optimal surgical techniques and meticulous wound care to minimize post-operative complications. Addressing malnutrition and promoting adequate nutrition supports optimal healing. Early diagnosis of surgical site issues is crucial to prevent complications leading to hernia formation. Patient education on post-operative care and community engagement in healthcare awareness play essential roles in promoting early detection and timely intervention. Strengthening healthcare infrastructure enhances access to surgical care and improves management outcomes despite resource challenges in the region.