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Purpose: This study aimed to determine patients' experiences following inguinal hernia repair at a tertiary hospital and associated cottage hospital in terms of postherniorraphy pain and follow-up., Methods: After exclusions, 373 adult patients undergoing inguinal hernia repair at Derriford and Tavistock hospitals during a 1-year period from October 2017 were sent a questionnaire regarding preoperative pain experience, current symptoms, and pain severity at 28 days and other intervals postoperatively. Statistical analysis of responses included unpaired t test to compare means and χ 2 test for discrete variables with a p value < 0.05 regarded as statistically significant., Results: The survey response rate was 68% (253/373). The mean pain score on visual analogue scale was 1.5 at 28 days postoperatively in those without preoperative pain compared to 3.2 in those with preoperative pain (p = 0.0001). Although 64 (25%) patients complained of pain at a mean follow-up of 47.9 ± 15.6 weeks, pain severity was insignificant after 28 days. Gender, employment status and mesh type did not affect pain scores. Return to normal activity after laparoscopic repair was longer than after open repair (5.4 ± 3.4 versus 4.2 ± 2.2 weeks, respectively; p = 0.0322). Overall, 34.6% thought follow-up was necessary and patients were more likely to agree with a decision not to follow them up., Conclusion: This study puts postherniorrhaphy pain in perspective of preoperative pain. Active discussion with patients prior to discharge or telephone follow-up by an appropriate individual may reduce the need for hospital follow-up.

Purpose: The use of prophylactic antibiotics in the mesh repair of inguinal hernias remains controversial. The aim of this study was to determine the perception of surgeons about surgical site infection and how this affects their clinical practice., Methods: A SurveyMonkey of general surgeons and senior surgical trainees was conducted via the local trust network and the questionnaire was displayed on the website of the Association of Surgeons of Great Britain and Ireland and Association of Surgeons in Training., Results: Eighty-one responses were received from surgeons who perform an average of 75 hernia repairs per year - the majority by open technique. Thirty-six (44.4%) used routine antibiotic prophylaxis, 40 (49.4%) selectively, and five (6.2%) not at all as the five surgeons who did not use antibiotics perceived their surgical site infection rate to be <1% and have never removed an infected mesh from a hernia wound. There was no clear difference between those who use prophylactic antibiotics routinely or selectively as the experience of mesh explantation is similar (56% versus 55% had 2-10 meshes removed respectively). Seventy-seven (95%) of surgeons felt a new specific set of guidelines was required., Conclusion: This study highlights the fact that in the absence of clear guidelines, most surgeons base their use of prophylactic antibiotics on their perceived risk or experience of surgical site infection. There is a strong need for a new set of guidelines to address the use of prophylactic antibiotics in groin hernia surgery.