Post operative care

GROIN HERNIA SURGERY

Before surgery

Patients should be encouraged to drink plenty of fluids for two days leading up to the operation. Patients should also eat plenty of fiber containing foods during this period as this helps avoid constipation and pain after the operation. Patients can take laxatives if needed. Indeed gentle laxatives such as Senna or Lactulose taken for the first two days after the operation may help reduce pain and constipation.

After surgery

Patients should be encouraged to take any prescribed tablets for pain only if they need them. Avoid prescribing tablets that contain codeine (e.g. Co-codamol). Paracetamol is almost as effective. Other non-steroidals (Voltarol, Naproxen) are fine providing there are no contraindications.

Wound care

A slight rise in body temperature may persist for a day or so after the operation irrespective of the type of anaesthetic used. This is normal. Patients should be encouraged to bath at least daily after the operation. A see-through plastic dressing will cover the wound and can be peeled off after 3-7 days. Clean bath water will do the wound/incision no harm at all.

There may be bruising and hardness or a sensation of a ‘rope’ beneath the incision (after an open mesh repair). In addition there may be swelling and bruising in the genital region. This will all disappear in time and patients should be reassured. After a laparoscopic repair the patient may feel that the hernia is still there but this sensation also improves with time. Scrotal swelling can be alarming irrespective of the type of repair, especially if the hernia was large or inguino-scrotal, and again patients should be reassured. If the swelling increases then a seroma should be considered which may need aspiration and contacting the surgeon is advised.

Infection

Fortunately this is uncommon. The majority of wounds are ‘inflamed’ after surgery and antibiotics are not necessary. Many surgeons may give a single dose of an appropriate antibiotic to minimize any chance of infection although this is not evidence based.

Postoperative mobility

This should be encouraged and patients should keep as active as possible (within reason). Their physical activity should not be restricted but common sense is needed. Driving after the operation is difficult. No driving for the first 7-10 is probably the best advise and patients should be seen and examined for their safety (and others) if they wish to return earlier. Clearly there is no fast rule on this and many Insurance companies have ‘fine’ print in the cover they offer.

More information

can be found by reading Surgical Clinics of North America 2003; 83: 1255-78 or online at www.rcseng.ac.uk/patients/get-well-soon/groin-hernia-repair