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POSTOPERATIVE INSTRUCTIONS

GENERAL POSTOPERATIVE INSTRUCTIONS

DRESSINGS

Minor Procedures

If it is on the face then you will generally have a small dressing which should be kept clean and dry until your first appointment in one week’s time. It will likely be skin coloured micropore tape which will cover the stitches. The stitches are removed at one week and you will be given the results of your pathology then. If the pathology is more urgent then you will receive an earlier phone call with the results.

Major Procedures

The specific dressings will vary according to the procedure but where possible they will be waterproof so that you can shower on Day 1 postoperatively. Usually there will be a couple of layers to the dressing which helps to keep it watertight and this will be removed by our fully trained plastic surgical nursing staff at either 1 or 2 weeks depending on the dressing.

DRAINS

Depending on the procedure there may be several drains coming out of the wound. Drains can be uncomfortable and can cause brief pain on removal. For this reason wherever possible we minimise the use of drains. However unfortunately they are a necessary evil for some procedures. The drains evacuate the fluid that accumulates after surgery and enables you to heal faster. This fluid is called serous fluid and it is that same clear yellow fluid that you may have noticed if you have grazed your knee. The same fluid is produced on the inside of the body and may collect to form a seroma. Drains minimise this fluid and improve the final result.

SUTURES

Most of the sutures are dissolvable and under the skin and can’t be seen. They don’t need removal.  There may be some sutures which need to be removed which is usually at day 7.

BINDER

After your procedure you may be fitted with a binder which you are required to wear for 6 weeks. The binder protects the repair, supports the wound and helps to stop fluid accumulation. It will also reduce the amount of swelling and bruising that is normal to get postoperatively. This can be removed to shower or for special events when the binder may be seen under clothing.

PAIN RELIEF

Major operations by their nature will have some degree of pain involved. Your surgeon will let you know the specifics of your procedure. The pain is generally not as bad as expected. Pain relief is very important and we take it seriously. Often you will need 1 or 2 doses of stronger medication through the drip for the first night and after this the rest of your pain relief can be taken in tablet form.  The best option for larger or combined procedures is called a Patient Controlled Analgesia (PCA) device which allows you to control the amount of medication given to you via a drip.  This will be discussed with you by the anaesthetist before the operation.

MOBILITY

You will be encouraged to mobilise on the first post-operative day and your mobility will progressively increase over the next few days.  This is critical as the most important thing you can do to prevent DVT (deep vein thrombosis) is to walk. It also speeds your recovery and decreases the chances of other complications.  Your inpatient stay will depend on the procedure but many operations can be performed as day cases or overnight stays. Light activity such as a fast walk that raises a sweat is comfortable at 4 weeks. Sporting activities and heavy lifting should be avoided for about 6 weeks.

TIME OFF WORK

For minor procedures done in our rooms you literally only need the time off for the procedure itself which is usually about 30 minutes. Similarly most day case operations only require one day off work.
For major procedures the usual timeframe is 1-2 weeks however this depends on the actual procedure and the nature of your employment. Please ask your surgeon for a more accurate guide

DRIVING

You will be permitted to drive 1-3 weeks after your procedure depending on the type of surgery.

SENSATION

It is not uncommon for the skin around the scar and the area that has been operated on to be numb after the operation. This is normal and does not mean that a major nerve has been cut. It occurs because when an incision is made or skin has been removed then there is damage to microscopic nerves which can’t be seen. If you feel tingling, burning, or shooting pains this is not cause for alarm and in fact is an indication that the small sensory nerves are regenerating.  This feeling will disappear with time and the sensation will return but it can take a long time to return to normal and it will continue to improve for up to 2 years.

SCAR MANAGEMENT

Horizon Plastic Surgery advises scar management to start 2-3 weeks after your surgery or when the wounds are healed. You can either tape the wounds with micropore which will provide support to the wound and then moisturise and massage each time the tape is removed. This tape can stay on for 2-3 days each time. If you are finding that your skin is becoming irritated then please discontinue use and contact our nursing staff who will advise you of a course of action. For high risk patients you may be prescribed a silicone gel tape called sicacare which can aid in reducing scar formation and can be bought from the chemist. Scar management should be continued until 3 months post surgery.

TED STOCKINGS

You will usually be required to wear TED stockings for compression to prevent DVT (blood clotting in the legs) post-operatively.  If required these will be fitted at the hospital on your admission day.  They are generally only worn whilst you are in hospital.

MEDICATION

You will be discharged with both pain relief and antibiotic medications.  Please take as directed. Most medications you ceased prior to surgery can be recommenced 1 week after your surgery but this will be individualised to each patient so please ask your surgeon.