Convalescence after inguinal herniorrhaphy.
BACKGROUND
Convalescence after inguinal herniorrhaphy is usually 3-4 weeks and is an important outcome parameter of hernia surgery. The aim of this study was to describe in detail the consequences of recommending a short convalescence, including the risk of recurrence.


METHODS
This was a multicentre prospective questionnaire study in patients given a recommendation for short convalescence (1 day); information was recorded on expected length of convalescence, employment status, physical workload and limiting factors. The reoperation rate in patients included in the study (group 1, n = 1059) was compared with that for comparable patients treated in participating departments but not part of the study group (group 2, n = 1306) and patients in the Danish Hernia Database (group 3, n = 8297).


RESULTS
The median time off work was 7 days and the time interval before carrying out the most strenuous leisure activity was 14 days. After 30 days, 6.8 per cent of patients had not resumed employment and 17.0 per cent had not yet resumed strenuous leisure activity. Important reasons for not resuming work and leisure activity were pain (approximately 60 per cent of patients) and wound problems (approximately 20 per cent). The reoperation rate in group 1 at the median observation time was 0.7 per cent, which was no different to that in group 2 (1.6 per cent) (P = 0.186) or group 3 (1.4 per cent) (P = 0.092).


CONCLUSIONS
Reduced convalescence after inguinal herniorrhaphy may be recommended without incurring a risk of higher reoperation rates. Pain and wound problems remain the most important factors for not resuming work or leisure activity as recommended.
Department of Surgical Gastroenterology, Hvidovre Hospital, Hvidovre, Denmark. morten.bay.nielsen@hh.hosp.dk
M
M
Bay-Nielsen
H
H
Thomsen
F Heidemann
FH
Andersen
J H
JH
Bendix
O K
OK
Sørensen
N
N
Skovgaard
H
H
Kehlet
D000328:Adult; D000368:Aged; D003289:Convalescence; D006552:Hernia, Inguinal / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors; D055502:Secondary Prevention