Early return to work after repair of a unilateral inguinal hernia

Abstract

Ninety-seven Royal Naval and Royal Marine officers and ratings undergoing repair of a unilateral inguinal hernia were randomized postoperatively into two groups: A, those who returned to full working duties 21 days after operation; B, those who returned to light duties 21 days after operation and to full duties at 3 months. Patients were reviewed at 3 and 12 months. One patient was withdrawn because of the development of late sepsis. Two patients in group B developed a recurrence of hernia within 1 year. No patient who returned to full duties at 21 days was unable to do any duty assigned to him. In a concurrent trial 119 male civilian patients were treated in the same hospital under identical conditions. All patients were reviewed 21 days after operation and were randomized into two groups: C, those advised to return to work immediately; D, those given no advice. Patients in group C returned to work in a mean of 38 days (range 14-96 days), whereas those in group D returned in a mean of 71 days (range 14-280 days). There was no recurrence of hernia in either group within the review period. It is concluded that there is no contraindication to resuming physical work 3 weeks after the uncomplicated repair of a unilateral inguinal hernia, and that active encouragement shortens the interval before return to work.

Risk and prognosis of inguinal hernia in relation to occupational mechanical exposures - a systematic review of the epidemiologic evidence

“…Of the 11 original papers on risk, 8 assessed the risk of inguinal hernia in relation to occupation or occupational exposures (2,3,11,12,38,39,41,42) and 3 assessed the risk of inguinal hernia in rela-tion to a single strenuous event (43)(44)(45). Of 12 original papers on post-operative prognosis, 7 concerned recurrence (35,40,(46)(47)(48)(49)(50) and 6 concerned persistent pain (49,(51)(52)(53)(54)(55); 1 provided results on both outcomes (49).…”

“…Duration of post-operative sickness absence was considered in seven studies (35, 46-48, 50, 51, 53), but was not described in relation to occupational exposures in two of these studies (50,51). In three studies, part of the patients received standardized advice on short postoperative sickness absence (35,46,48). Five studies did not take account of duration of post-operative sickness absence (40,49,52,54,55).…”

“…The brief descriptions that follow are arranged first according to prognostic outcome (recurrence or persistent pain), second by year of publication, and third alphabetically according to the first author's surname. The seven studies on recurrence (35,40,(46)(47)(48)(49)(50) are also presented in table 2.…”

O uso da prótese na correção das hérnias da parede abdominal é um avanço, mas o seu uso indiscriminado, um abuso

“…Com o passar do tempo, é relativamente comum que estas coleções serosas e assépticas se tornem purulentas. Nestes casos, a retirada total ou parcial das partes seqüestradas da prótese, freqüentemente é necessária, pois é pouco provável que a integração da prótese tenha ocorrido 27 . Da mesma forma que as próteses planas, que estimulam a fibroplasia e a incorporação tecidual, os tampões ("plugs"), sejam maciços ou em forma de cones, podem também criar, ao seu redor, um espaço preenchido por serosidade.…”

Clinical study of patients with inguinal hernia at a tertiary care hospital

“…The accepted explanation for this is the physiologic "shutter mechanism" which is activated when the abdominal muscles contract and raise the intraabdominal pressure to increase when performing these functions. 13 Cooper stated that the cause of hernia was mechanical disparity between visceral pressure and the resistance of the abdominal musculature.…”