Return home (After)

• Length of stay: Day hospitalisation or 1 night (overnight stay).
• Day hospital: Discharge from hospital before 6pm. 
• After overnight stay discharge is scheduled before 2 pm.
• Discharge is planned when the patient can eat independently and mobilize autonomously. A bowel mouvement is not necessary before discharge.
• For patients who are not independent, it is important to contact the social service quickly, even before hospitalization, to organise home care or post-operative rehabilitation.

Social service contact details:

+32 2 614 92 92

• At admission, it is important to hand over, as soon as possible, all the certificates to be filled in: Insurance, mutual insurance, sports club certificate, disability certificate…
• Make sure you recollect all your certificates completed at discharge.

Analgesic on discharge from hospital:

• Paracétamol: Dafalgan® 1gr 3-4x /day
• Non-steroidal anti-inflammatory drugs: Brufen® 400mg 3x /day
• Morphine: Tradonal® retard 50 mg max 6x /day if needed

In normal circumstances, pain is controlled with a combination of paracetamol, non-steroidal anti-inflammatory drugs and morphine.
When pain subsides, morphine should be stopped first, then non-steroidal anti-inflammatory drugs and lastly paracetamol.

Morphine can cause nausea and vomiting. To alleviate these side effects, it may be necessary to take an anti-emetic (against nausea) tablet. (Litican® 50mg, Litican® 10mg….)

Non-steroidal anti-inflammatory drugs: (Brufen®, Brexine®, Nurofen®, Apranax®, Catafam®,…) should not be taken chronically.
Chronic intake of non-steroidal anti-inflammatory drugs may cause bleeding due to inflammation of the stomach (gastritis) and stomach ulcers.

Wound pain increases with physical activities or sudden movements (laughing, coughing, mobilization, etc.). The pain is caused by tension on the sutures and small movements of the mesh against the abdominal wall during sudden movements.

To reduce the tension on the scar and pain, we recommend supporting the abdominal wall by putting your hands, a pillow, jumper and pressing on the scar.

It is not necessary to take antibiotics at home.

• Anticoagulants are necessary after surgery with prolonged immobilization, obesity, history of deep vein thrombosis or pulmonary embolism and in case of surgery in the small pelvis. The purpose of anticoagulants is to reduce the risk of deep vein thrombosis (blood clots). Blood clots can break loose and potentially clog blood vessels in the lungs ( pulmonary embolism). Pulmonary embolisms can be fatal.

ANTICOAGULANT: CLEXANE® – FRAXIPARINE®

• Subcutaneous injection into the abdomen or thighs
• Dosage according to weight for at least 10 – 20 days
• There is an exception if anticoagulants (Sintrom®, Xarelto®, Clopidogrel®…) are taken at home

Postoperatively, Clexane® is administered to the patient . When the risk of postoperative bleeding is considered limited, Clexane® will be stopped and the anticoagulant resumed. Whether or not to resume the anticoagulant Sintrom®, Xarelto® or Clopidogrel®…. will be decided by the surgeon.

COMPRESSION STOCKINGS

• It is recommended to wear compression stockings overday for 10 to 20 days after surgery. At night the compression stockings may be removed.

Shower: → Immediately with waterproof dressings.

Bath: → 10 days after removal off the bandages.

Walk: → Immediately.

Sleeping position: → No position is contraindicated (back, stomach, side…)

Car: → Immediately (avoid long trips in the first week).

Stairs: → Immediately.

Physical activity: → Lifting < 10 kg: 4 – 6 weeks.

Sport: → 4 – 6 weeks.

Professional activity:

→ Manual/physical work: 4 – 6 weeks.

→ Sedentary office work: 7 – 10 days.

Sexual activity:

→ 7 – 10 days.

Daytime

• Plasticized or not plasticized (paper) dressing.
• The dressing should be renewed only if it becomes loose or if the wound becomes moist.
• If you have a (allergic) reaction to the plasticized dressings (itching, blisters or redness at the edges of the dressing), change them to non-plasticized dressing.

When showering

• Do not rub the dressings while showering.
• Patients with non-plasticized dressing due to a skin reaction to plasticized dressings will have to protect the wound with a plastic film while showering.
• If you put on a plasticized bandage: You should not change your bandage before showering unless it has already come off and is no longer waterproof. You should also apply a new dressing if it comes off while showering.

See the section on Wound care.

There you will find information, photos and videos on the different dressings and how to change them.

Link to the section: Wound care

The patients can resume a normal diet, on the same day as the surgical procedure.

No postoperative diet.

Link to chapter : Nutrition

• Consultation 5 days after surgery with GP (General practician).
• After 10 – 14 days, consultation with your surgeon to check postoperative evolution (wounds, nutrition, general condition).

Normal symptoms

In normal circumstances, pain is easily controlled with paracetamol (Dafalgan®) and pain symptoms diminish over time

• Urinary Retention may occur in the first hours after the procedure. Temporary placement of a urinary catheter may be necessary.
• Nausea and vomiting  (24–48 hours) may occur. Adolescents and especially young women are more affected.
• Hardening and pain at the level of the scar. The wound may feel hard for several weeks.
• Pain is often aggravated by sudden movements of the abdominal wall laughing, coughing, sneezing,…).
• Groin or testicular pain disappears after a few weeks.
• Swelling at the site of the hernia after surgery (seroma): Collection of wound fluid and blood that fills the void left after treatment of the hernia.

• Red or purple coloration of the penis or scrotum: Ecchymosis caused by blood and wound fluid penetrating the subcutaneous tissues of the penis and scrotum. The colour slowly recedes spontaneously within 2 week.

Abnormal symptoms

If certain symptoms seem abnormal to you, or if you have persistent fever or acute pain that increases over time, contact your doctor.

If this is not possible, you can contact your surgeon.

If you are unable to contact your GP or surgeon, go to the emergency department at St Elizabeth Hospital in Uccle.

– Work incapacity depends on the occupational activity and the patient’s age.

• For a physical occupation, the incapacity is at least 4 – 6 weeks.
• For office – sedentary work, the incapacity is at least 7 – 10 days.

– Physical recovery depends on age and preoperative physical condition.

– Most patients experience (severe) fatigue after the euphoria of returning home.