Best Treatment for Wound Dehiscence and How to Prevent it?

Best treatment for wound dehiscence and how to prevent it? Photo by Alexander Grey:

Best treatment of wound dehiscence is a topic of great interest as wound dehiscence is one of the main complications that people face after a surgery. 

Depending on the site of the surgery and the severity, treatment of wound dehiscence differs but the distress people undergo remains almost the same.

 

What is Wound Dehiscence?

 

Wound dehiscence occurs as a complication when you receive sutures from a surgery. The wound edges may reopen partially or fully due to the defects in the wound healing mechanism making a new wound. 

Ultimate result is that wound will take a lot of time to heal causing you unnecessary trouble.

Usually, you will notice this within one week after surgery as during this time, the wound healing process is still in early stages.

There are two main aspects of wound dehiscence. 

Superficial wound dehiscence is when the most superficial layers of wound edges are separated whereas Full thickness dehiscence is when the underlying deep layers are also involved and separated completely.

In full thickness dehiscence, if the wound is situated on a cavity as in the abdomen, this can open a pathway from the inside of the cavity to the outside as well. If so, there is a risk of internal organs coming out of this pathway. This is Evisceration. 

Evisceration is a very dangerous consequence of wound dehiscence that needs urgent proper treatment.

Tensile Strength

During the first few days of the skin wound, the tensile strength of the wound is minimal. But as the collagen tissue forms, the wound tissue will increase its tensile strength over time. 

Thus, wound dehiscence is more likely during the first few days of the wound.

  

Causes and Risk Factors of Wound Dehiscence

 

Causes and Risk factors related to the Patient

Age

Increasing age is a risk factor for wound dehiscence.

 

Malnutrition

If you have any nutritional deficiency like anemia, hypoalbuminemia, vitamin deficiencies etc. it will result in poor wound healing that will in turn can cause wound dehiscence. Most importantly, vitamin c deficiency, zinc deficiency, protein deficiency can reduce wound healing.

 

Best Abdominal Exercises Post-Hernia Surgery: A Safe Recovery Guide

Best Abdominal Exercises Post-Hernia Surgery: A Safe Recovery Guide
Photo by Andrej Klintsy:

After hernia repair surgery, patients often wonder: When can I exercise again? What ab workouts are safe?

While strengthening your core is important for preventing recurrence, doing the wrong exercises too soon can cause re-injury.  

As a doctor facing these kinds of questions, I’ll guide you through:  

✔ When to start exercising after hernia surgery 

✔ The safest abdominal exercises for recovery

✔ Movements to avoid (they can re-open your incision!)

✔ A phased workout plan (weeks 1–12+)

By following this doctor-approved ab workout plan, you’ll rebuild strength without compromising your healing.

When Can You Start Ab Exercises After Hernia Surgery?

General Timeline 

Key rules:

1. Always follow your surgeon’s advice first!

2. Stop immediately if you feel pain at the incision site. 

When can you start abs exercises after hernia surgery - General work out plan

Phase 1: Gentle Core Re-Activation (Weeks 3–8)

 

Start with low-impact isometric exercises (no crunching or twisting!).  

1. Diaphragmatic Breathing

✅ How: Lie on your back, inhale deeply through your nose (let belly rise), exhale fully.  

✅ Why: Re-engages transverse abdominis (deep core muscle).  

2. Pelvic Tilts

✅ How: Lie on back, knees bent. Gently flatten lower back into floor (engage core).  

✅ Reps: 10x, 2 sets daily.  

3. Heel Slides

✅ How: Lie on back, slowly slide one heel away (keep core braced).  

✅ Avoid: If you feel pulling near the incision.  

4. Seated Marches

✅ How: Sit tall, alternate lifting knees slightly (no hunching!).  

✅ Goal: Improve circulation without strain.  

Phase 2: Progressive Strengthening (Weeks 8–12+)

Once cleared by your doctor, add these safe abdominal exercises:  

1. Dead Bug Exercise

✅ How: Lie on back, arms toward ceiling. Slowly lower opposite arm/leg (keep core tight).  

✅ Tip: Place a pillow under hips if needed.  

2. Modified Plank (Forearm or Wall)

✅ How: Start with wall planks (lean at 45°), progress to forearm planks (knees down).  

✅ Avoid: Full planks until 3+ months post-op.

3. Bird Dogs

✅ How: On hands/knees, extend opposite arm/leg (keep hips level).  

✅ Bonus: Improves balance + core stability.  

4. Standing Core Exercises

✅ Examples:  

- Standing knee lifts (hold a chair for balance).  

- Pallof press (use resistance band anchored to wall).  

Exercises to AVOID After Hernia Surgery

❌ Crunches/sit-ups as these increase intra-abdominal pressure.

❌ Heavy weightlifting (wait 3–6 months for deadlifts).  

❌ Twisting motions (Russian twists, oblique bends).  

❌ High-impact cardio (running, jumping – wait 12 weeks).  

Why?

These can strain the mesh/repair site and cause recurrence.  

FAQ: Your Top Questions Answered

1. When can I do sit-ups after hernia surgery?

Not for at least 3–6 months (if ever—opt for safer alternatives like dead bugs).  

2. Can I lift weights after hernia repair?

Light weights (5–10 lbs) at 8+ weeks; heavy lifting only after 6 months with surgeon approval.  

3. How do I know if I’m overdoing it?

Warning signs: Sharp pain, bulging at incision, or swelling. 

This means that your hernia has recurred. Hence, do not overdo your exercises and that’s a must!

4. Will exercise prevent another hernia?

Yes! A strong core reduces pressure on weak spots—but progress slowly.  You will not develop a strong core overnight. Isn’t it? Give it the time needed.

Sample 12-Week Post-Op Ab Workout Plan 

Here is a summary of what we have discussed. You can use the following sample 12 week post hernia operation ab work out plan.

Sample 12 week post hernia operation Ab workout plan

  

Final Tip: Listen to Your Body

Recovery varies—some patients resume light jogging at 8 weeks while others need 6 months for heavy lifting. 

Always prioritise proper form over intensity.

Bookmark this guide and share it with your physical therapist or surgeon to customise your plan. 

Good luck!

From Dr. Pasindu

Stay happy stay healthy!

 

Do you like What you just read? 
Share it with your friends and loved ones too!

 

Follow our FACEBOOK page for more articles like this!

#healthfactsbydrpasindu #healthfactsbydoctorpasindu #herniasurgery #recoveryafterherniasurgery #howtopreventherniarecurrence #lifestyle #healthfacts #wellbeing #symptomsandsigns #herniasurgerytips #generalsurgery #abexercisesafterherniasurgery #safecoreworkouts #exerciseaftersurgery #abworkout

Hernia Surgery: Types, Recovery, and Prevention – A Surgeon’s Guide

Hernia Surgery: Types, Recovery, and Prevention – A Surgeon’s Guide
Photo by cottonbro studio:

A hernia occurs when an organ or fatty tissue pushes through a weak spot in the surrounding muscle or connective tissue. 

Common types include inguinal (groin), umbilical (belly button), hiatal (upper stomach), and incisional (resulting from a surgical scar) hernias. 

While some hernias cause minimal discomfort, others require hernia repair surgery to prevent serious complications like strangulation (loss of blood flow to the trapped tissue).  

In this comprehensive guide, we’ll cover:  

- Different types of hernia surgery (open vs. laparoscopic)  

- Recovery timeline after hernia repair

- How to prevent hernias from recurring  

- Risks and success rates

By the end, you’ll understand whether hernia surgery is right for you and how to ensure a smooth recovery.  

What Is a Hernia and When Is Surgery Needed?

A hernia doesn’t always require immediate surgery, but hernia repair surgery becomes necessary if:  

✔ The hernia is painful or growing

✔ It becomes incarcerated (stuck) or strangulated (a medical emergency)  

✔ Lifestyle changes and supportive garments no longer help

Ignoring a hernia can lead to severe complications, making timely surgical intervention crucial.

Types of Hernia Surgery

There are three primary surgical approaches, each with its own benefits and recovery process.  

1. Open Hernia Repair (Herniorrhaphy/Hernioplasty)  

A single large incision is made near the hernia site. The surgeon pushes the protruding tissue back into place and reinforces the weakened area with a synthetic mesh (hernioplasty) or stitches (herniorrhaphy).  

This is best for: Large or complex hernias.  

Recovery time is 2–4 weeks for light activities and 6–8 weeks for heavy lifting.  

2. Laparoscopic Hernia Repair (Minimally Invasive Surgery)

Small incisions are made, and a tiny camera (laparoscope) guides the surgeon to repair the hernia using mesh.  

Less post operative pain, smaller scars, and faster recovery (1–2 weeks) are the benefits of this procedure.

This way is ideal for recurrent hernias or bilateral (both sides) inguinal hernias.  

3. Robotic-Assisted Hernia Surgery

This is similar to laparoscopic surgery but performed with robotic precision for complex cases.  

Enhanced 3D visualisation is useful for the surgeon.

Recovery is Comparable to laparoscopic repair.  

Your surgeon will recommend the best type based on hernia size, location, and your overall health.

Hernia Surgery Recovery Timeline

First 24–48 Hours After Surgery

- Pain management is of prime importance. Prescription or OTC pain relievers would work.

- Activity: Rest, but walk short distances to prevent blood clots.  

- Diet: Start with liquids, then progress to soft foods.  

1–2 Weeks Post-Surgery

- Driving: Usually allowed after 1 week (if off strong pain meds).  

- Work: Desk jobs can resume in 1 week; manual labor may require about 4 weeks.  

- Avoid: Heavy lifting, straining, or intense exercise. Although it may feel too exaggerated, usually patients are advised not to lift a weight more than a cup of tea in this period.

3–6 Weeks Post-Surgery

- You can gradually return to your normal activities.  

- Physical therapy may help strengthen the abdominal muscles.  

- Follow-up visit to surgeon to check the wound healing progress.  

Long-Term Recovery

- Full recovery takes 3–6 months for strenuous activities.  

- Scar tissue softens over time.  

How to Prevent Hernia Recurrence

Even after surgery, hernias can return. Following these hernia prevention tips would reduce the recurrence rates.

1. Strengthen Your Core

- Practice low-impact exercises (e.g., swimming, Pilates).  

- Avoid sit-ups or heavy weightlifting initially.  

- Check out my article on Best abdominal exercises post hernia surgery: a safe recovery guide to see what are the safe ab exercises you can do post hernia surgery.

2. Maintain a Healthy Weight

- Excess weight increases abdominal pressure.  

3. Avoid Straining

- Use proper lifting techniques (bend at the knees, not waist).  

- Treat chronic coughs or constipation (they increase hernia risk).  

4. Follow Post-Op Instructions

- Wear an abdominal binder if recommended.  

- Attend all follow-up appointments.  

Risks and Complications of Hernia Surgery

While generally safe, potential risks of hernia surgery include: 

- Infection (redness, fever, pus – requires antibiotics).  

- Nerve damage (numbness or chronic pain).  

- Mesh rejection or adhesion (rare but may need revision surgery).  

- Recurrence (5–10% risk, higher without mesh).  

Choosing an experienced hernia surgeon minimises these risks.

What are the Non-Surgical Alternatives? (When Surgery Isn’t an Option)

For high-risk patients, alternatives include:  

- Watchful waiting (for small, asymptomatic hernias).  

- Truss (hernia belt) – temporary relief but not a cure.  

Most importantly it is noteworthy to remind you that these don’t fix the hernia—only surgery can fully repair it.

Frequently Asked Questions (FAQs)

1. How long does hernia surgery take?

- Open repair: 30–60 minutes.  

- Laparoscopic: 45–90 minutes.  

2. Will I need general anesthesia?

Most laparoscopic/robotic surgeries use general anesthesia; some open repairs use local anesthesia.  

3. When can I exercise after hernia surgery?

- Light walking: Day 1

- Gym/running: 4–6 weeks (with surgeon’s approval).  

4. How successful is hernia surgery?

90–95% success rate with mesh; slightly lower without.  

5. Can hernias heal without surgery?

No—they only worsen over time. Surgery is the only permanent fix.  

Final Thoughts: Is Hernia Surgery Right for You?

If you have a painful, enlarging, or trapped hernia, surgery is often the best solution. Modern techniques like laparoscopic and robotic hernia repair offer quicker recoveries and minimal scarring.  

Consult a general surgeon to discuss your options. Early intervention prevents complications like bowel obstruction or tissue death.  

Good luck!

From Dr. Pasindu

Stay happy stay healthy!

 

Do you like What you just read? 
Share it with your friends and loved ones too!

 

Follow our FACEBOOK page for more articles like this!

#healthfactsbydrpasindu #healthfactsbydoctorpasindu #herniasurgery #recoveryafterherniasurgery #howtopreventherniarecurrence #lifestyle #healthfacts #wellbeing #symptomsandsigns #laparoscopicherniasurgery #openherniasurgery #herniasurgerytips #generalsurgery

 

Carpal Tunnel Surgery: When Is It Necessary? A Surgeon’s Guide

Carpal Tunnel Surgery: When is it Necessary? Photo by Viktors Duks

Today I want to talk to you about another common surgical ailment. 

Carpal tunnel syndrome (CTS) is a common condition that causes pain, numbness, and tingling in the hand and arm. 

It occurs when the median nerve, which runs from the forearm into the palm, becomes compressed at the wrist. 

While non-surgical treatments like braces, medications, and steroid injections often help, carpal tunnel surgery may be necessary in severe or persistent cases.  

In this article, we’ll explore:  

- What makes carpal tunnel surgery necessary

- The different types of carpal tunnel release surgery  

- Recovery time after carpal tunnel surgery

- Risks and success rates  

- Non-surgical alternatives  

By the end, you’ll have a clear understanding of whether carpal tunnel release surgery is the right choice for you.  

What Is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow passageway in the wrist made up of bones and ligaments. The median nerve and tendons pass through this tunnel. 

When swelling or inflammation narrows this space, pressure on the nerve leads to carpal tunnel syndrome symptoms, including:  

- Numbness or tingling in the thumb, index, middle, and ring fingers  

- Weak grip strength  

- Pain radiating up the arm  

- Nighttime hand discomfort that disrupts sleep  

If left untreated, CTS can lead to permanent nerve damage and muscle wasting.  

When Is Carpal Tunnel Surgery Necessary?

Not everyone with CTS needs surgery. Doctors typically recommend carpal tunnel release surgery when:  

1. Non-Surgical Treatments Fail

Before considering surgery, most patients try:  

- Wrist splinting (especially at night)  

- Anti-inflammatory medications (NSAIDs)  

- Corticosteroid injections to reduce swelling  

If symptoms persist after 6-12 months of conservative treatment, carpal tunnel surgery may be necessary.  

2. Severe Nerve Compression (Confirmed by EMG/NCS)

An electromyography (EMG) or nerve conduction study (NCS) can measure how badly the median nerve is compressed. 

If results show severe nerve damage, surgery is often the best option to prevent permanent weakness.  

3. Muscle Weakness or Wasting

In advanced cases, patients may notice:  

- Thumb muscle atrophy (shrinking of the thenar muscles)  

- Difficulty gripping objects (e.g., dropping cups or keys)  

These signs indicate significant nerve damage, making carpal tunnel release surgery urgent.  

Types of Carpal Tunnel Surgery

There are two main surgical techniques:  

1. Open Carpal Tunnel Release (OCTR)

- A small incision (about 2 inches) is made in the palm.  

- The surgeon cuts the transverse carpal ligament or flexor retinaculum to relieve pressure.  

- Recovery takes about 4-6 weeks, with stitches removed in 10-14 days.  

2. Endoscopic Carpal Tunnel Surgery (ECTR)

- A tiny camera (endoscope) and instruments are inserted through a smaller incision.  

- Faster recovery (2-4 weeks) and less post-op pain.  

- Slightly higher risk of nerve injury compared to open surgery.  

Both methods have high carpal tunnel surgery success rates (85-90%).  

What to Expect During Recovery?

First Week After Surgery

- Pain and swelling are common (managed with ice and painkillers).  

- Keep the hand elevated to reduce swelling.  

- Avoid heavy lifting or strenuous activity.  

2-6 Weeks Post-Surgery

- Gradually resume light activities.  

- Physical therapy may help regain strength.  

- Most patients return to work in 2-4 weeks (desk jobs) or 6-8 weeks (manual labor).  

Long-Term Results

- Numbness and tingling will usually improve quickly.  

- Grip strength may take 3-6 months to fully return.  

- Scar tenderness fades over time.  

Risks and Complications of Carpal Tunnel Surgery

While Carpal Tunnel Surgery is generally a safe procedure, this too can have possible risks which include:  

- Infection (rare, treated with antibiotics)  

- Nerve damage (uncommon but can cause lingering numbness)  

- Scar tissue formation (may lead to stiffness)  

- Incomplete relief (5-10% of cases require revision surgery)  

Choosing an experienced hand surgeon reduces these risks.  

Related Reading Material:

Interesting Factors Influencing Wound Healing Process in a Nutshell!

Non-Surgical Alternatives to Consider

If you’re not ready for surgery, try:  

- Nighttime wrist splints which keeps the wrist in a neutral position.

- Ergonomic adjustments like adjusting the keyboard height, mouse use etc.  

- Cortisone injections that gives a temporary relief for 3-6 months.

- Physical therapy like nerve gliding exercises etc.

However, if symptoms worsen, the carpal tunnel surgery may be the best long-term solution.  

A person wearing a night time wrist splint Photo by SHVETS production

Frequently Asked Questions (FAQs)

1. How successful is carpal tunnel surgery? 

Most patients (85-90%) experience significant relief. Full recovery depends on nerve damage severity before surgery.  

2. How long does carpal tunnel surgery take?

The procedure itself takes about 10-30 minutes, usually done under local anesthesia while a tourniquet in place in your arm.

3. Will I need physical therapy after surgery?

Not always, but gentle exercises can speed up recovery.  

4. Can carpal tunnel syndrome come back after surgery?

Recurrence is rare (<5%) but possible if underlying causes (like repetitive strain) persist.  

5. When can I drive after carpal tunnel surgery?

Most patients can resume driving in 1-2 weeks if pain is controlled.  

Final Thoughts: Is Carpal Tunnel Surgery Right for You?

If you’ve tried non-surgical treatments without relief, or if you have severe numbness, weakness, or muscle wasting, carpal tunnel release surgery may be necessary. 

The procedure is quick, effective, and has a high success rate.  

Consult a hand specialist to discuss whether open or endoscopic carpal tunnel surgery is best for you. 

Early intervention can prevent permanent nerve damage and restore hand function.  

From Dr. Pasindu 🥰

Stay happy stay healthy!

 

Do you like What you just read?
Share it with your friends and loved ones too!

 

Follow our FACEBOOK page for more articles like this!

#healthfactsbydrpasindu #healthfactsbydoctorpasindu #carpaltunnelsyndrome #carpaltunnelsurgery #lifestyle #healthfacts #wellbeing #symptomsandsigns #orthopedics