Hernia Wound Healing

Hernia Healing Process

At some point during your hernia repair journey, you may ask some of the following questions: How long does the hernia surgery wound take to heal up? Can I damage my healing wound? Why can’t I play sports? Why must I avoid heavy lifting?

We know these concerns are on your mind, and we’re here to provide some clear, reassuring answers. We believe it’s helpful to understand a bit more about what’s happening inside your body during the hernia wound healing process so that you allow time for the repair to strengthen.

The Four Phases of Wound Healing Post Hernia Surgery:

Phase 1: Bleeding

This phase involves stopping any bleeding by sealing the leaky edges of the wound. When platelet cells from the blood vessels encounter collagen fibres (outside blood vessels), it sets off a coagulation cascade. This clot then forms a stable plug of cells by depositing fibrin – the scab.

This is the body’s emergency response to tissue injury (a surgical wound). Leaving the wound covered for the first week, or so, quickens the healing process and reduces chances of infection.

Phase 2: Inflammatory

Once the plug is stable, small capillary blood vessels open bringing more oxygen to the wound.

The wound attracts white blood cells (neutrophils) to the scene which mature into macrophages. Macrophages clean up the wound, removing dead cells and any contaminants.

The wound is filled with oxygenated fluid and cells, becoming swollen, red, warm, and tender. Although this can be uncomfortable, these are normal symptoms of hernia wound healing and should be left alone.

Phase 3: Proliferative

The cells that are brought in start to multiply and mature to further the healing.

The fibrin used to make the plug stable attracts fibroblasts. Fibroblasts secrete procollagen, and procollagen bridges the gap between the 2 sides of a wound.

The procollagen joins together to make collagen fibrils that are short and laid down in a haphazard fashion filling in the gap.
This is essential to ensure that the repair heals and strengthens.

Phase 4: Remodelling

These collagen fibrils are building blocks that will join together to form long collagen fibres. During this phase of healing, gently exercising, moving and stretching the scar over time improves its flexibility and long-term comfort. Myofibroblasts are another type of specialised cell that come from fibroblasts (remember that thing from Phase 3 that secrets procollagen?). Myofibroblasts help to contract the scarring tissue and form elastic cross-bridges making the scar neater, finer, and stronger still. Our post-surgery exercise programme is particularly beneficial during this phase of wound healing.

These phases are overlapping. Each phase of wound healing can be delayed or sped up by altering the environment the wound exists in. For example:

If you take blood thinning medication too soon after surgery, it can dissolve the clot and make it take longer to organise enough fibrin to become a stable plug in Phase 1. Once the clot is stabilised by fibrin, it will not dissolve.
If you have a medical condition or habit that reduces oxygen supply such as: smoking, obesity, diabetes, lung disease or peripheral vascular disease, then the Inflammation and Proliferation phases are slowed down.
Bacterial infection, wound contamination, excess fatty cells, etc. take longer to clear away, making the Inflammatory Phase last longer. Being older and frailer also makes these latter phases take longer.

Wound Strength Over Time

The wound changes shape and colour through the 4 phases of wound healing.

Research* shows that it takes 6-8 weeks for a wound to get to about 80% strength. The final wound does not get much stronger than this.

*published in Plastic and Reconstructive Surgery—Global Open, 2013 (doi:10.1097/GOX.0b013e31828ff9f4)

Recovery After Hernia Surgery

We provide valuable advice on what to expect after surgery and how to get the best results from your recovery and returning to activity.

You will also be given access to our effective Rehabilitation Exercise Programme, specially designed to help you get back to activity safely and to restrengthen your repair.

Your Follow Up Consultation

We will reach out to book your post-surgery follow up around 4 weeks after your operation to assess your repair and recovery.

Book your consultation today

to discuss your options with our consultant surgeon