Gen Surg Post-Op Instructions
The surgeon who performs your child’s procedure will speak to you as soon as the surgery is finished. Very soon after that, you will be allowed to see your child in the recovery room, hopefully as soon as they start to wake up.
If, after reviewing the information on this page, you have further questions, please be sure to discuss them with your child’s surgeon at the time of surgery. Write your questions down and bring them with you on the day of the surgery, so that an important question will not be forgotten.
Our hope is that by reading this, you will know what to expect on the day of surgery and that the experience that you and your child have will be as pleasant as possible.
Generally speaking, your child is not allowed to bathe for 48 hours following the surgery. Some exceptions may apply, such as isolated circumcisions, in which case bathing is allowed 24 hours after the surgery. Up until the time that bathing is allowed, a sponge bath may be given.
Diaper wipes may be used to clean the diaper area and, if necessary, a squirt bottle of water may be used to moisten the area around the incision to allow it to be cleaned more easily.
Bleeding is expected in small amounts and may stain the diaper or cause the gauze to turn red or become soaked. Bleeding is more common after incisions to the scrotum and penis. If the blood is dripping off the wound or leaking out from under the dressing, apply gentle direct pressure to the site for 15 minutes. If this does not stop the bleeding, call the surgeon and/or take the child to an emergency room. Please note that some bruising and swelling may also occur. It is not unusual to see some bruising of the skin beginning a few days after the surgery, as it takes a while for the blood to reach up to the skin level.
If your child occasionally takes medications for constipation, you should be sure to give them these medications before the surgery and also on the day of surgery after they arrive home. Constipation can be a significant problem following surgery, especially for those children who require narcotic type medications or who have lower abdominal surgery.
If constipation occurs following the surgery, we recommend the following:
- Infants: Take apple juice or prune juice
- Children: Take 1-2 tablespoons of Milk of Magnesia or 1-2 small chocolate Ex-Lax squares. (These are well tolerated and are effective.)
Do not allow constipation to continue unchecked for 2-3 days following surgery. If this occurs, it can become a major problem, causing more discomfort than the surgery itself.
After surgery, your child will not wake up hungry. In general, give your child liquids until they arrive home, and then advance the intake of food as tolerated. Most patients can eat a normal dinner on the day of surgery.
It is common for the patient to have a fever under 101 degrees during the first 24 hours after an operation. This is a normal reaction to the anesthesia. No specific treatment is required for this; however, Tylenol may help to bring down the temperature.
You will be advised if and when the surgeon would like you to return for a follow-up visit. (In some cases, a follow-up visit is not required.)
Pain and Discomfort
In order to eliminate pain immediately following surgery, a long-acting local anesthetic is used.
If the child has no pain following surgery, give Ibuprofen four hours after the surgery finishes, so that the medicine will already be working when the local anesthetic wears off. Give the pain medication as soon as your child starts to feel any pain and repeat every six hours as needed. In addition, Tylenol can be given every four hours. (Tylenol and Ibuprofen work differently in the body and can be given at the same time.)
Also, placement of an ice pack on the surgery site will cut down on swelling and will eventually lead to numbness and a more rapid recovery. The ice pack can be placed on the surgery site intermittently in the first 24 hours following surgery.
Most children will limit their own activities and specific restrictions may not be given. For example, a three-year-old will usually stop running and jumping if it causes him or her pain and discomfort. Once the pain resolves, it will be safe for the child to resume normal activity.
Older children who are enrolled in P.E. classes and other organized sports may have some limitations. Each case is different, so be sure to clarify this with your surgeon after the procedure. Let your child’s physician know ahead of time if your child requires a specific note for school.
In general, gauze bandages should be removed 24-48 hours after the surgery, but the small paper tapes (Steri Strips) should be left in place until they fall off. Two to three weeks after the surgery, and after the Steri Strips fall off, any adhesive left on the skin can be removed with acetone or nail polish remover. In some cases, the wound will be closed with a skin adhesive called Dermabond, which is very similar to Crazy Glue. If Dermabond is used to seal the incision, there will most likely be no Steri Strips.
Please note that it is normal for the incision to be hard for two to three months following surgery. This is due to the stitches, which are underneath the skin and take two to three months to completely dissolve. The incision will be a thin pink or purple line that will become the color of normal skin a few months following the surgery.
If you are instructed to apply ointment to the incision, this should be done approximately four times a day or during diaper changes for the first two to three days. After that time, the incision will generally seal over and additional ointment is not required. The preferred ointment is an antibiotic ointment, which has several brand names such as Neosporin, Polysporin or Bacitracin.