What to Expect After Surgery
These are some general guidelines to help you along in the early days after surgery. While the information provided here can be applied to most surgical procedures, you should always follow the specific instructions provided by your surgeon.
Depending on the type of surgery, your skin incisions may be closed with adhesive glue and absorbable sutures, or with stitches or surgical staples.
If glue is used, the glue is waterproof immediately and requires no special care. You should begin showering starting on the day after surgery, using your normal skin soap. The glue will gradually wear away over 1-2 weeks.
If stitches/staples are used, your skin incisions are covered with a gauze dressing. You should remove the dressing completely on the second day after surgery. You may then wash the incision (including the staples) in the shower with soap/water directly on the incision. The staples/stitches will be removed when you come back to clinic.
Avoid soaking for prolonged periods of time in a pool or hot tub for 3 weeks after surgery to allow the incisions to fully heal.
The skin at the edge of the incision may be slightly red or raised – this is normal. If the redness extends out away from the incision in a larger pattern over time, you should call our office. You may also develop a dark red or purple colored bruise under the skin around the incision. This is due to a small amount of oozing from tiny blood vessels in the skin, and will slowly resolve by itself with time.
Keeping the incision covered is recommended only if the area is draining, in order to protect your clothing. Some drainage is normal - this can be clear or red-tinged in color. If the drainage has a foul odor or becomes purulent (thick white or yellow) then call our office. For excessive drainage, use gauze or a sanitary napkin to wick the moisture away from the skin. Antibiotic creams and other skin treatments are generally not recommended.
You have been given a prescription for a narcotic pain medicine to use as needed for immediate postoperative pain control. Take this medicine as needed only when you are experiencing pain. You may also use over-the-counter pain medicines such Tylenol or Motrin for less severe pain. Be aware that your prescription pain medicine may also contain Tylenol (Acetaminophen). If you choose to take additional over-the-counter Tylenol, DO NOT take more than 4000 mg of Acetaminophen per 24 hours. Ask your surgeon or pharmacist if you have any questions.
The “gas pain” you may experience within the first 1-2 days after laparoscopic surgery is not typically caused by gas within the bowel itself, but instead by irritation caused by the pressurized gas around the abdominal organs. Therefore, traditional therapies such as Gas X, Mylicon, or other over-the-counter remedies may not be helpful. Walking, movement, and time will allow the gas to dissipate and the muscles to become less sore. As the bowels begin to “wake up,” you may experience gas bloating or cramping that comes and goes – this type of pain may respond to anti-gas medications.
You may also experience pain in one or both shoulders for several days after laparoscopic surgery. This is most likely referred pain from an irritated diaphragm (the muscle that separates the chest from the belly), which is again caused by the pressurized gas used during surgery. This should slowly improve over several days.
After inguinal (groin) hernia repair, some patients find it helpful to wear a jock strap or some type of support briefs to stabilize and support the genital region. You may develop significant bruising, swelling, or discoloration of this area. This is normal, as this area is the most gravity-dependent region below the groins and the operative site. The use of ice packs or heating pads is recommended if you find it helpful.
To counter the constipating effects of narcotic pain medications, drink plenty of fluids and use over-the-counter stool softeners. Recommended stool softeners include Colace, Senokot, and Milk of Magnesia or any other mild laxative. Suppositories and enemas may also be used, but if your surgery involved the colon or rectum be sure to check with your surgeon first. Very strong laxatives such as Miralax, Go-lytely, etc are not usually recommended in the postoperative period.
Moving may be uncomfortable initially, but it does help work out the soreness in the abdominal muscles caused by the pressurized gas used during laparoscopic surgery.
After most major abdominal operations, you should not lift anything more than 30 lbs and avoid activities that require significant straining with your abdominal muscles for 4 weeks after surgery. This is to allow the deep muscle sutures to heal completely and avoid a future hernia. Walking, jogging, driving, climbing stairs, and other activities are encouraged as long as they are not causing significant discomfort.
Return to Work
You may return to work when you feel that you are able to perform your job duties without significant pain or discomfort, as long as the above lifting restrictions are followed. You do not need to wait until your follow-up clinic visit to return to work. If you need a work release note, please contact our office and we can fax it to you or your employer.
When to Contact Us
In addition to the postoperative pain described above, you may experience some other minor symptoms in the first 1-3 days after surgery. These may include low-grade fevers (less than 100ºF), constipation, itching or mild rashes (reaction to pain medications), sore throat (from the breathing tube), and mild cough or headaches. In general, as long as things are improving slowly each day, you should not be overly concerned.
You should contact our office BEFORE your scheduled appointment if you experience the following:
- Repeated, high fevers > 101.5º F
- Chills or severe night sweats associated with high fevers
- Increasing redness, warmth, swelling, or cloudy drainage at the incision sites
- Nausea or vomiting preventing you from drinking fluids or eating > 1 day
- Persisting constipation resulting in severe bloating, abdominal pain, or vomiting
- Worsening pain beyond 2-3 days after surgery
- Low blood pressure (upper number <90), rapid pulse (> 120), or severe fatigue or light-headedness
- New or worsening shortness of breath
- New or worsening chest pain
- Inability to pass urine, persistent burning or bleeding with urination
How to Contact Us
For questions or concerns, you may call Hickory Surgical Clinic at 828-327-9178. If you need to contact us after business hours or during the weekend, call the office number and follow the instructions to contact the surgeon who is on call.