Post Operative Care

On discharge, a referral is usually made to the district nursing service who will visit the patient and assist with wound dressings and drain care. Depending on the type of surgery performed, the wound is dressed with steristrip and water-proof opsite dressing. The water-proof dressing can be removed after 5 – 7 days and the steristrip left on or replaced for another week. The patient is advised to keep the wound dry for the first 7 days. Subsequently, the patient can shower without the waterproof dressings and the wound gently pat dry with a soft towel. Soap and cream should be avoided on the wound in the first 4 weeks.

If a drain is inserted during surgery, the patient is often discharged home with the drain. The district nursing service will provide wound and drain care in the community. The volume of drainage in the drain bottle over a 24 hour period is measured daily and recorded on a drainage chart. The drain is removed by the district nurse if it drains less than 40ml/day or on Day 14 after surgery.

Once the drain is removed, it is not uncommon for the body to continue to produce fluid within the operative site. This collection of fluid is called a seroma. This is usually reabsorbed over time but if a large volume is produced, it may result in a visible swelling and can become uncomfortable. This usually requires needle aspiration which may be repeated as necessary (usually once a week or once every 2 weeks) until resolution of the collection. This is a fairly common occurence and is not urgent unless there is an underlying infection of the seroma. This in itself is uncommon but if it occurs, an urgent needle aspiration as well as antibiotics is required.

Once discharged, the patient is encouraged to gently mobilize and remain active. Gentle arm exercise is important, aiming for a full range of shoulder movement within 2 – 4 weeks after surgery. An information sheet with instructions on arm exercises will be given on discharge from hospital.

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