Open Ventral Hernia Surgery Care Instructions
What to Expect
Plan to stay in the hospital as an inpatient 5-7 days after your procedure. Depending on the size of your hernia, at times you will spend the initial night after surgery in the intensive care unit.
Repair of your ventral (abdominal) hernia does not require any dietary restrictions after surgery. Many patients find that their appetite is poor for a week or two after surgery. This is a normal result of the stress of surgery and manipulation inside the belly – your appetite should return in time. If you find you are persistently nauseated or unable to take in liquids after discharge, contact our office and let us know.
When you get out of surgery you may have a drain, commonly called a Jackson Pratt or JP drain, inserted near your incision. The drain provides suction to drain excess fluid around the surgical area. There is a bulb connected to the drain that will collect the fluid once it is drained. The drain promotes healing and reduces the risk of infection. In most cases, your drain will remain in place until you have approximately 30 milliliters or less per day for 2 days in a row. Sometimes patients are sent home with drains for a few days; follow your instructions for caring for and emptying your JP drains, and record all output from the JP drain.
Depending on your procedure you may have staples to close your incision. Staples will stay in for the first 2-3 weeks after surgery, and removed at a post-op office visit. You can shower with them in, but no baths, hot tubs, or pools for the first two weeks after surgery. Initially there may be some fluid leaking out, around where the drain was, this is okay, just cover them with dry sterile gauze.
We try to close your incisions to leave the smallest possible scar. Do not put any ointment or other medication on your incisions – it will not make them “heal better.”
We ask you to wear your abdominal binder for the first 6 weeks as much as possible, including while sleeping. Most patients find this provides added comfort and reduces pain. At times back pain can develop from overuse due to painful abdomen muscles. This binder will help support your abdomen and relieve pressure on your back. It is also important to reduce the fluid that accumulates above the mesh after the repair.
There are some restrictions on your activity after your hernia repair. While every person recovers differently, you should count on a full 6 week recovery period. You should plan on taking it easy, especially in the first few weeks after surgery. In general, all strenuous and exerting activity should be avoided until you are told you may do so. If it doesn’t feel good, don’t do it. Make sure to ask for help with basic activities such as grocery shopping, cooking, and yard work. This is mainly to protect the incision while it heals.
You may also feel easily fatigued and “washed out” for a few weeks following the surgery. These factors will put some limitations on your activity.
Everyone returns to work at different times. As a rough guide, most people take at least 4-6 weeks off prior to returning to work. If you need particular documentation for your job, call the office.
You will usually be released to drive generally when you have not needed the narcotic (prescription) pain medications for two consecutive days, and when you feel up to it – when you can get in and out of the car without discomfort, and breaking can be performed without difficulty or pain. Plan for help driving to and from your appointments.
The first bowel movement may occur anywhere from 5 days after surgery – as long as you are not nauseated or having abdominal pain this variation is acceptable. Many patients have loose bowel movements, diarrhea, for a week or two – the bowels usually become more regular with time. Constipation can become a problem for some patients post-op, and straining will increase abdominal discomfort. You will be prescribed medications to help alleviate this problem, please use as directed. Often milk of magnesia 2 tablespoons twice a day can help alleviate this problem. This can be continued until you are off narcotics and your bowels have returned to normal. Call the office if this persists for >5 days.
Some patients find that their hernia “returns” right after surgery. Don’t worry – this is a normal feeling and/or appearance. The hernia repair did not fail – the place where the hernia contents were can sometimes fill up with post-operative fluid – this fluid is a normal result of dissection and will usually be absorbed by the body in several weeks. Wearing your binder will help reduce/compress this fluid.
When to call
Call your surgeon’s office if any of the following occur:
- Fever to 100.4 or greater
- Shaking chills
- Pain that increases over time
- Redness, warmth, or pus draining from incision sites
- Persistent nausea or inability to take in liquids