Postoperative care is the care received by an operated patient after a surgical procedure. Recovering from surgery shouldn’t be complicated, but it will take some time and energy along with a willingness to follow the instructions provided by the operating surgeon. Now a days, on cost considerations early discharge from hospitals have become common. Many family members prefer an early discharge from the operation as it helps to reduce the cost and gives a respite to family members from being at hospital environment. Early discharge is being promoted by the insurance companies also.

At the time of discharge a number of instructions are given by the surgeon. A surprisingly large number of people do not follow those instructions and then wonder why they are having pain, healing slowly, or both. One should know that a healing body needs time to heal and won’t tolerate being rushed. If the instructions given the doctors are not well cared, then such lapses will result in post operation complications and also in improper cure with residual pain.

What are the key requirements for proper recovery?

The type of postoperative care required depends on the type of surgery that has been performed and as well on the age of the patient and also on pre-existing comorbidities like diabetes, hypertension etc. For most surgery patients it is truly that simple. For others, healing quickly requires diligence and effort in caring for their incision, and their body as a whole, after surgery.  Here are some helpful hints to know as to why some operated patients suffer from post operation complications.

a.      Not flowing Doctor’s Instructions: Every surgeon gives instructions regarding post operation care. Some patients follow the instructions. There are others who follow only those instructions which they feel to be meaningful and disregard the ones that they don’t like or don’t feel apply to them. This is very often ends in improper or poor recovery.

b.      Inability to provide proper care in home settings: Home care is not always suitable for recovery of aged patients who have undergone major procedures for the following reasons. 

                                                              i.      Lack of proper infrastructure for post operation care: A home is never designed for a recovery of an operated person. Some common reasons are given below;

1.      The room where the patient is kept may not be well aerated.

2.      It might not have an attached toilet.

3.      The toilet door may not be big enough to carry a wheel chair.

4.      The toilet might be raised above the room flooring.

5.      The toilet may not have a western commode.

6.      The patient might require a cot similar to Fowlers bed, and it may not be available at home.

7.      There might not be a meals table for the patient to be fed properly….. and many more.

                                                            ii.      Family care givers busy with their daily life: These are the days of nuclear families, especially in urban settings. Every one in the family is busy with their own life. Many may not be in a position to leave their jobs to take care of the patient at home and it is especially true for aged patients. Sometimes, some help is sought from man power supply agencies to take care of the recovering patients. Most of the personnel provided by home care agencies can not handle post operation cases. At best they can take care of the aged who are normal. 

                                                          iii.      Pre-existing Diseases & Conditions: Pre-existing diseases and conditions like Diabetes, Hypertension, Kidney mal-functioning, COPD and Asthma, Cardiac problems, Parkinson’s disease, previous stroke related issues, Epilepsy, Urinary incontinence, Bed sores can complicate the process of recovery, especially in the aged patients. Family members may not be in a position to deal with these complications. A hypoglycaemic attack suffered by an operated patient, for instance, can be disastrous. 

c.       Not taking measures to prevent infection: It is very important to ensure that the patient recovering from an operation should not be affected any type of infection. Even a common cold or cough can turn into pneumonia, especially among the aged patients. Sometimes on account of unhygienic conditions, patients might suffer from vomiting or from loose motion. Coughing can be disastrous and may lead to rupture of wound suture. Such situations lead to slow recovery with poor outcomes.

d.      Age of the patient: Aged patients who are dependent on others for daily activities suffer most when do not get proper and timely help. Development of pressure ulcers and bed sores is common with aged patients who are cared properly in home serttings.

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f.        Inspect Your Incision: Looking at your incision may not be your favourite thing to do, but it is important that you take a good look at your incision several times a day. Now there are procedures where this isn’t possible, but for the vast majority of procedures, a mirror makes it possible to have a good look at the surgical site. Is your incision pink or red? Is there wound drainage and what color is it? Are the stitches or staples intact? These questions are very important and looking at your incision several times a day will help you determine if your surgical site is continuing to heal or if it has become infected.

g.      You know you should wash your hands before touching your incision, but then what? Caring for your incision doesn’t need to be complicated or difficult.

h.      Believe it or not, most patients try to get their incision a bit too clean. They want to scrub their incision and remove the scabs that form, or they want to use alcohol or peroxide to keep the area free of germs. Unless your surgeon specifically instructs you to do any of those things, a gentle wash with soap and water is more than adequate.4

i.        It may not be pretty, but it is normal to have scabbing on your surgical staples. Removing them could actually cause your incision to heal far more slowly.

j.        Soaking your incision in an effort to keep it clean can also be harmful because it can weaken the incision line. Many surgeons recommend showers instead of baths following surgery and often forbid swimming during the early stages of recovery.

k.       Drink and Eat Properly: Many people don’t feel like eating after having surgery. They are nauseated, constipated, or just not hungry. Staying hydrated and eating a healthy diet after surgery can help promote healing, minimize common complications, and help you get past unwanted side effects of anaesthesia.

l.        Cough and Sneeze Carefully: Who knew that coughing and sneezing the way you’ve been doing it your entire life isn’t good enough after some surgeries? It turns out that if you have an abdominal incision, you can do some serious harm to your incision if you cough or sneeze the wrong way. A new incision isn’t very strong and a violent sneeze can actually cause a surgical incision to open. Bracing your incision, which means applying pressure to the incision, is essential when coughing, sneezing or even going to the bathroom. You can do this with your hands, or a pillow if you have one nearby. Just remember that coughing is important and you should be coughing frequently after surgery. Coughing helps prevent pneumonia.

m.    Control Your Pain: Keeping your pain under control is very important after surgery. Some patients hesitate to take their pain medication as prescribed because they fear addiction or other issues. Others feel that taking pain medication is a sign of weakness, or they don’t like how they feel when they take prescription drugs. However, if you are in too much pain to cough, you are at risk for pneumonia. If you are in too much pain to walk, you are at risk for blood clots and pneumonia. Keeping your pain at a tolerable level (no pain may be an unreasonable goal) will help you keep moving and speed the healing process.5 Just make sure to drink ample fluids along with pain medications, as they can lead to dehydration and constipation. It is often easier to control pain if you take the medication regularly, as prescribed. Waiting until the pain is severe and then taking pain medication results in a long wait for the drug to take effect.It is better to keep the pain under control and at a tolerable level, rather than waiting until it is severe and waiting for relief. Good pain control can make it far easier to sleep, which also promotes healing.

n.      Get Moving: Walking after surgery is one of the most important things you can do after having a procedure. It may seem like a simple thing, but a quick walk every hour or two can help prevent serious complications like deep vein thrombosis (DVT) and pneumonia. Walking can also help prevent one very common and annoying side effect of anesthesia—constipation. Walking is a gentle way to return to physical activity and can help promote a return to regular activities. Talk to your surgeon about when you can return to more strenuous activities, such as running and contact sports. Swimming should wait until your wound is completely closed.