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January 17, 1972

Convalescence After Herniorrhaphy

Author Affiliations

Los Angeles

JAMA. 1972;219(3):388. doi:10.1001/jama.1972.03190290071028

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To the Editor.—  Certainly I agree with Kerry that all inguinal hernias should be repaired before participation in school athletic programs.However, his statement that "(after operation) activity too early is likely to cause undue strain on the hernia repair and thereby increase the possibility of recurrence" is open to scrutiny. Our work (Surg Gynec Obstet130:685, 1970) demonstrates that, during the first eight weeks after operation, wound healing does not contribute to the strength of the sutured wound. A healing wound acquires only 40% of intact tissue strength from wound healing by two months. The same structures, repaired with strong nonabsorbable suture, achieve 70% of intact tissue strength immediately; this is maintained throughout the next two months, exceeding at all times the tensile strength attributable to the healing process. The quality of the approximated aponeurotic tissue and the strength of the suture material are the factors determining the