Postoperative Care at home
Postoperative care refers to the care that a patient receives after a surgery/operation. The type of postoperative care required by the patient depends on the type of surgery as well as the health history of the patient. It usually includes pain management and wound care. Postoperative care starts immediately after surgery. It lasts from the duration of the hospital stay and may continue even after the patient is discharged from the hospital.
The patient should ask their doctor any questions before their surgery and they should also ask for updated instructions before being discharged from the hospital. Most hospitals provide written discharge instructions. Some general questions that the patient might ask their doctor is about the expected time duration of their hospital stay, any special medications, any change in diet that should be followed, possible complications and side effects after surgery when to resume normal activity, physiotherapy, or exercises that need to be followed, any instructions that enhance or delays the recovery.
The following things should be considered by the patient after surgery:
1. Follow the doctor’s recommendation
The hospital provides a discharge summary with a list of things that should be done and that should not be done. Carefully follow those orders even if it seems trivial because no one understands a patient’s condition better than their doctor. Do not hesitate to ask the doctor about anything that seems doubtful.
2. Wound care
The wound should not be scrubbed or rubbed roughly. Stitches or staples should not be picked. Any product (lotion, cream, etc.) should not be applied unless approved by the doctor. Keep the wound dry and clean. Tight clothes should be avoided because that may restrict the blood flow to the wound. Handwashing should be performed before and after handling the wound. If the doctor has prescribed antibiotics, then take them as prescribed.
Consider visiting the nearest medical/clinics/hospitals for dressing the incision site if the risks of infection seem to persist by home care.
3. Danger signs and complications
Before leaving the hospital, patients should ask the doctor and nurses about danger signs and possible complications that they need to watch out for at home.
The most common signs of postoperative infection include:
º Fever or high temperature
º Unusual or excessive pain
º Redness in or around the wound
º Swelling or hardening on the area surrounding the incision
º A change in the size or odor of the incision
º Green or yellow discharge from the wound
º Excessive bleeding that soaks or seeps through the bandages
Some other signs that might indicate postoperative complications besides wound site infection are as follows:
º Difficulty in breathing
º Excessive tiredness or drowsiness
º Inability to drink or eat
º Inability to urinate
The patient must visit the hospital and consult the doctor in case of the presence of any signs mentioned above.
4. Medicines
The doctor might provide the medicines like analgesics (to relieve pain), antibiotics (to reduce the risk of infections) along with some vitamins, laxatives (stool softener), proton pump inhibitors (for relieving gastritis), etc as needed.
Medicines should be taken as prescribed for rapid recovery and to avoid any kind of complications.
5. Diet and Nutrition
Having a healthy, balanced, and appropriate diet according to surgical conditions is crucial for the body to recover fully at a faster rate. The doctor tells you about the diet that should be followed for your condition, such as a clear or full liquid diet before transitioning to solid foods is required in case of gastrointestinal tract surgery (surgery related to the stomach or intestines).
Usually, a good postoperative diet includes whole grains, an ample amount of fruits and vegetables, lean protein (such as lentils, yogurt, white-fleshed fish, skinless white meat, low-fat milk, etc), and healthy fats. Also, consider other factors such as allergies, medications, and preferences.
6. Hydration
Water is not only essential to transport nutrients but also to flush out toxins from the body. Proper hydration is needed to have the energy to recover. Ask the doctor for specific details of your hydration because sometimes in patients with kidney/heart disease, excess water is restricted.
7. Ambulation/ walking
Heavy exercises or strenuous physical activity should not be immediately performed after surgery but breathing exercises (to ease the mind, manage pain, and exercise respiratory muscles) and walking lightly (to prevent complications like pneumonia and stroke-causing blood clots, to improve blood flow to help heal the incision wound faster, to keep yourself active enough to reduce the risk of bedsores and constipation) for a couple of minutes every hour or so is very important to regain strength and prevent complications.
8. Bedsores
Bedsores are ulcers on areas of the skin under pressure from lying in bed, sitting in a wheelchair, or wearing a cast for a prolonged time. They are also called pressure injuries, pressure sores, pressure ulcers, or decubitus ulcers.
Bedsores can develop if a bedridden person is not turned, positioned correctly, and given good nutrition and skincare. People with diabetes, circulation problems and poor nutrition are at higher risk. Once bedsore develops, it is often very slow to heal.
They can be prevented by inspecting the skin for areas of redness (the first sign of skin breakdown) every day with particular attention to bony areas (such as heels of feet, shoulder blades, buttocks area, back of the head, back and sides of the knees). Other methods of preventing bedsores are:
º Turning and repositioning every 2 hours
º Providing soft padding in beds to reduce pressure or using an air mattress
º Providing good skin care by keeping the skin clean and dry
º Providing good nutrition with enough calories, vitamins, minerals, fluids, and protein
9. Stop smoking
According to World Health Organization (WHO), the risk of complications after surgery is increased by smoking because it delays healing time and messes up the immune system. Smoking also reduces the body’s ability to deliver essential nutrients needed for recovery and also increases the possibility of developing an infection.
10. Mental health
Feeling anxious or depressed can increase the healing time by distracting the patient from having a healthy diet, doing appropriate exercise, and even interrupting sleep and rest. Consider listening to your favorite music, meditating, reading books, getting in touch with friends and family to relax your mind. Work on a hobby that you enjoy that helps you take your mind away from the worries and allows you to focus on recovery.
11. Follow-ups
DO NOT skip any follow-up appointments with the doctor. Please remember that the needs of a patient change each day that they recover. As the days pass, there may be changes required in medicines, diet, or activity. Follow-up check-ups also give the doctor a chance to look out for signs of any complications that allow for quick intervention.
12. Home care services
Finally, you can consider taking advantage of postoperative home care services if available in your region to recover as soon as possible. You can have doctors/nurses visit your home to assess your condition and improvement and to check/monitor your vital signs (such as blood pressure, breathing rate, pulse rate, temperature, oxygen saturation, etc and you may also approach the physiotherapist to perform appropriate exercises at home.
References:
1. Pietrangelo A. Postoperative Care [Internet]. USA: Healthline; 2018 Jul 7 [Cited on 2022 Mar 18]. Available from: Postoperative Care: Definition and Patient Education (healthline.com)
2. Bunag L. Post-Surgery Care At Home [Internet]. Singapore: Homage; Cited on 2022 Mar 21. Available from: Post-Surgery Care At Home: 12 Ways To Boost Recovery After Surgery - Homage
3. Bedsore [Internet]. Maryland, USA: Johns Hopkins Medicine; Cited on 2022 Mar 23. Available from: Bedsores | Johns Hopkins Medicine
By Bipsana Shrestha
Registered Nurse
Danphe Care