13. Postoperative care

Question 1

13. Postoperative care

Answer 1

Immediate postoperative concerns
-pain
-anxiety
-cardiorespiratory function
>blood pressure
>oxygen saturation
-temperature
-procedure-related factors
-wound protection
-postoperative period should be made as pleasant as possible

Postoperative care
-highest death rate 3 hours after extubation
-patient has to be closely monitored until it:
*has been extubated
*is laying on sternum,head elevated
*is able to swallow,has normal ocular reflex
*has a strong and regular peripheral pulse
*has an oxygen saturation of >94%
*has no suspicion of upper airway obstruction
*has effective analgesia
*has no evident bleeding

Postoperative care
-pain management
-nutritional management
-wound care(protection,antibacterials)
-care related to surgical procedure
-exercise restriction
-immobilization
-other care possibilities
-home care–instructions necessary!

Postoperative pain management
-better options for analgesia in the clinic–should be left as an inpatient until pain under control
-options for analgesia at home
*NSAIDs
*tramadol
*fentanyl/lidocaine patch
*Ca++ channel blockers(e.g.gabapentin)
*etc.
-length of treatment is determined by the procedure and the patient

Procedure-related care
-postoperative care depends on the surgical procedure and the condition of the patient
-catheterization
-feeding tubes
-limb immobilization
-laser therapy
-physiotherapy
*etc.

Wound protection

Wound care
-owner must be instructed in detail
-wound care should be provided daily(usually up to 14 days)
-wound exudate should be removed
-cleaning with physiological solution is recommended
-wound gels may be applied
-suture material usually removed after 7-14 days
-A follow-up is also warranted in case an intradermal pattern was used