The following is a list of general instructions for your care following your surgery. Please read them carefully several times as most of your questions should be answered here. Instructions for your care will also be reviewed the morning after surgery. Carefully following these instructions should help you get the best results from your surgery.
Most people can resume a normal diet the evening of surgery. If you feel queasy or nauseated, start with clear liquids or soup. Advance your diet as tolerated to a regular diet. You may experience some constipation as a result of the pain medication. Over the counter laxatives such as Milk of Magnesia or stool softener is recommended. If this is not sufficient, then dulcolax or a glycerin suppository may be necessary. This can be purchased over the counter at your pharmacy.
It is usually a good idea to avoid strenuous activity or exercise for the first 7-10 days after surgery. Walking and light activities are recommended instead. Be sure to walk at least 300 yards daily. This can be broken up in multiple short trips. It is OK and recommended that you walk more than the minimum of 300 yards. This will help prevent Deep Vein Thrombosis (DVT’s/Blood Clots) and Pulmonary Embolisms (PE’s). Exercise can usually be gradually initiated beginning 3-4 weeks after surgery. No core exercises until after 8 weeks. Heavy lifting (over 10 lbs. – the approximate weight of a gallon of milk) should be avoided until 6 weeks after surgery. Driving should be avoided if you are taking narcotic pain medications or if there is still significant pain from the surgery. Driving while either of these conditions are present could result in an unsafe driving situation. You should maintain your body in a position of flexion at the hips for the first 10 days or so after surgery. This helps the incision to heal properly by relieving tension. While lying down, assume a “V” position- place pillows under the knees and trunk or use a recliner. While standing or walking, bend slightly at the waist.
Unless you have an allergy to surgical glue, your incisions are sealed with a surgical glue and tape(see Dermabond Post-Care sheet that is attached). No ointment or Neosporin is needed for the incision line. Simply place dry/clean gauze along the incision line and then the surgical binder. The gauze helps prevent friction to the incisions. Swelling, bruising, and redness of the skin is normal and will resolve over time. Many patients have drainage from where the incisions often come together. This drainage is quite normal and may be bloody, yellow, or clear in color. Do Not apply a heating pad or ice to your incision or abdomen. After surgery you will have decreased sensation and heat/ice can result in a burn/frostbite without you feeling it. Smoking causes multiple wound healing complications. It is very important that you do not smoke and you are not around people that smoke for at least 6 weeks after surgery. Second hand smoke is just as harmful as if you were to smoke.
You may shower starting 48 hours after surgery, but NO BATHS. DO NOT let the shower water directly hit your incisions. When showering you can hold your drains, pin them to a belt around your waist, attach them to a lanyard or string around your neck, or a partner/family member can hold them. Do whatever is easiest for you. Following a shower, apply clean gauze to the incisions and put the abdominal binder on. The surgical binder should be worn at all times until the doctor advises otherwise. Apply the binder moderately tight but not so tight that it interferes with normal breathing. During the first 4 weeks wear your abdominal binder at all times except when showering. You will be provided with 2 binders at the hospital, one of which you will be wearing when you wake up following surgery.
See the separate Drain Instruction Sheet(attached). The drains should be emptied AT LEAST twice daily and the output recorded. The drainage will go from red, to yellow, and back to red. This is normal. Do not put the drain grenade or tubing under the bra or abdominal binder as this can cause a pressure ulcer. In addition, do not detach the tubing from the grenade, as this is a sterile one way environment. The drain exit site has an antibiotic disk over top. This only needs changed once a week unless the site becomes itchy or saturated. If this is the case, start daily dressing changes with Neosporin and clean gauze. Any residual surgical soap (yellow) or marker can be gently removed with rubbing alcohol.
Take the narcotic pain medicine as instructed and needed. Take your pain medication with food. This can be with as little as a few crackers. This will help prevent nausea. Do not drive until you are no longer taking the narcotics and are free of significant pain. AVOID ASPIRIN, or anti-inflammatory medications (Motrin, Aleve, etc.) for 2-3 days after surgery, as these may increase the risk of bleeding immediately after surgery. Tylenol is safe immediately after surgery and may be alternated with (or used in place of) prescribed pain medication. Dr. Bernacki will not refill any prescriptions. When your prescription medications are gone switch to the above recommended over the counter medications.In some cases, antibiotics may be prescribed.
Normal surgical pain and swelling should begin to gradually decrease 2-3 days after surgery. If you suspect infection at the surgical site, contact your provider as soon as possible to determine the appropriate treatment course.
Signs of bleeding: sudden increased swelling / mass-effect at the surgical site, drainage of blood from the wound, or severe bruising around the surgical site. Sudden onset (or increase) in pain can be a sign of bleeding as well. Drainage of a small or moderate amount of blood-tinged fluid, from the incisions or drain sites, is not uncommon and is usually not indicative of active bleeding. If there appears to be active bleeding, direct pressure on the site can be helpful. If you suspect significant bleeding following surgery, contact your provider to determine appropriate treatment.
Wound healing problems can manifest as separation of the skin edges or an open wound at the surgical site. This can be caused by a variety of factors and is usually a problem that can be managed by dressing changes and wound care. Keep the area clean and place a gauze dressing. Contact your provider to discuss need for further evaluation and treatment recommendations. If there is a problem, please call our office. Most issues are easily addressed and do not require significant intervention.
The most common emergencies that might need attention are:
If you feel the situation is urgent, call 911 and/or proceed directly to the closest emergency room.
Please call us as well.
Follow-up is typically in 7-10 days and should be scheduled by calling our office if it has not already been arranged.