Patient education: Abdominal wall hernia repair – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.

What is abdominal hernia repair? — The internal organs and tissues are held in place by a tough outer wall of tissue called the "abdominal wall." An abdominal hernia is an area in that wall that is weak or torn. Often, when there is a hernia, organs or tissues that are normally held in place by the abdominal wall bulge or stick out through the weak or torn spot.

There are many different kinds of abdominal wall hernias (figure 1).

Abdominal wall hernia repair can be done in 2 ways:

●Open surgery – During an open surgery, the doctor makes 1 large cut near the hernia to repair it.

●Minimally invasive surgery – "Minimally invasive" surgery lets the doctor make smaller cuts in the skin. They insert long, thin tools through the cuts. One of the tools has a camera (called a "laparoscope") on the end, which sends pictures to a TV screen. The doctor can look at the screen to see inside the body. Then, they use the long tools to do the surgery. They can control the tools directly, or with the help of a robot (this is called "robot-assisted" surgery).

How long it takes for you to recover, and what you need to do, depends on which type of surgery you had. If you had minimally invasive surgery, you might be able to return to your normal activities sooner. With open surgery, it usually takes longer to recover.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

For the first 24 hours after surgery:

●Do not drive or operate heavy or dangerous machinery.

●Do not make any important decisions or sign any important papers.

●Do not drink alcohol of any kind.

You should also:

●Take all of your medicines as instructed.

●Take care of your incision – You might have stitches, skin staples, surgical glue, or a special skin tape on your incision. If you had minimally invasive surgery, you might have more than 1 incision.

•Keep your incision dry and covered with a bandage for the first 1 to 2 days after surgery. Your doctor or nurse will tell you exactly how long to keep your incision dry.

•Once you no longer need to keep your incision dry, gently wash it with soap and water whenever you take a shower. Do not put your incision underwater, such as in a bath, pool, or lake. This can slow healing and raise your chance of getting an infection.

•After you wash your incision, pat it dry. Your doctor or nurse will tell you if you need to put an antibiotic ointment on the incision. They will also tell you if you need to cover your incision with a bandage or gauze.

•Always wash your hands before and after you touch your incision or bandage.

●Increase your activity slowly – Start with short walks around your home, and walk a little more each day.

•Keep coughing and doing deep breathing exercises for 7 to 10 days after you go home. This will help prevent lung infections. When you cough, sneeze, or do deep breathing exercises, press a pillow across your incision to support the wound and ease pain.

•Avoid heavy lifting, sports, and swimming for at least 3 to 4 weeks. (Your doctor or nurse will tell you exactly how long to avoid these or other activities.)

•It is generally OK to start having sex again when you feel ready, but talk to your doctor if you have any questions.

●Eat when you are hungry – If you have an upset stomach, it might help to start with clear liquids and foods that are easy to digest, like soup, pudding, toast, or eggs. You can eat other types of foods when you feel ready. If your doctor or nurse gave you specific instructions about what to eat or avoid, follow them.

●Use a stool softener to help prevent constipation, if needed. This is a common problem if you take opioid pain medicines. Eating foods that are high in fiber can also help (figure 2).

●Be aware that if you had minimally invasive surgery, you might have some pain in your shoulder. This is from gas that the doctor put into your belly during the surgery. Walking and moving around will help to reduce the gas and ease the pain.

●Use a small pillow to put pressure on your belly. This can make you more comfortable when you cough, laugh, or do other actions.

●Use ice for the first 2 to 3 days after your surgery to help with swelling. To do this, put a cold gel pack, bag of ice, or bag of frozen vegetables on the affected area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and your skin.

●Get treatment if you have problems such as constipation or cough. These can cause you to strain the area where you had the repair.

What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress. Go to these appointments.

If you have stitches or staples, you will need to have them taken out. Your doctor will usually want to do this in 1 to 2 weeks. Some stitches absorb on their own and do not need to be removed. If the doctor used skin glue or tape, it will fall off on its own. Do not pick at it or try to remove it yourself.

When should I call the doctor? — Call for advice if:

●You have a fever of 100.4°F (38°C) or higher, or chills.

●You have redness, swelling, or drainage around the incisions from your surgery.

●You have severe nausea or vomiting, and cannot keep food or drink down.

●You think that your hernia has come back.

●You develop a "seroma" or "hematoma" – These are when fluid starts to build up between 2 layers of tissue in the body.

More on this topic

Patient education: Abdominal wall hernia repair (The Basics)
Patient education: Abdominal wall hernias (The Basics)