Recovering From Surgery

Once the surgeon, anaesthetist and other hospital team members have done their jobs and you are discharged from hospital, the next stage of your surgical journey is your recovery. One of the most important things you can do for your post-op recovery is to monitor your health closely.

Before you leave the hospital, your surgeon or nurse will let you know what to expect over the coming days and weeks while you recover. They should give you information on:¹

• Contact information if you need assistance or start to feel unwell.
• Wound care – how many dressings you will need/how and when to change dressings/how much bleeding to be expected.
• Follow up appointments.
• Ongoing treatment or further surgeries.
• Medicines – whether to stop or restart your usual ones, or start new medications.
• Referral to support services (district nurses for dressing changes, wound care), home help, physiotherapy.
• Any special equipment required (crutches, raised toilet seat, pickup claw, frames, knee scooters).
• Help needed for compression stockings.
• Whether stitches are absorbable or need removal.
• How to mobilise, get in and out of bed or a chair.
• Consideration of any obstacles at home such as stairs or steps, furniture, trip hazards, and how accessible your bath and shower are.

Post-surgery complications

With any surgery there is a risk of wound infection as well as the potential for blood clots. A deep vein thrombosis (DVT) is when a blood clot forms in the veins of the legs or sometimes the pelvis. A pulmonary embolism (PE) is a life-threatening clot that has travelled to the lungs and blocks the blood supply.

Correct wound care can minimise the risk of your wound getting infected. Keep your wound clean and dry. Shower rather than bathe and pat gently afterwards with a clean towel. Wet or soiled dressings may need to be replaced. Don’t touch the wound unnecessarily and always wash hands with soap and water.

Ways to prevent blood clots forming includes wearing compression stockings, movement and hydration. Stockings may need to be worn for up to two weeks or until freely mobile. Get mobile with short walks if possible. Stand frequently and undertake gentle exercises (ankle circles, foot pumps, knee lifts, shoulder roll, arm curls). Stay well hydrated by drinking at least one litre of fluid a day.

It is important to know the signs for infection and blood clots:

Infection²

• increased pain, redness or swelling in and around your wound
• increased temperature (fever and/or chills)
• feeling generally unwell
• excess bleeding or wound ooze
• skin around the wound feels hot to touch.

Blood clots³

Sudden shortness of breath, sudden chest pain or coughing up blood or blood-stained mucous are a medical emergency. Call 111 and let them know of your recent surgery if you experience any of these symptoms.

Pain in your pelvis or pain, swelling, redness or tenderness in the legs can indicate a DVT – you need to be seen by a doctor promptly if you experience this.

Contact your surgeon or GP if you start to feel unwell or experience other symptoms such as –

• nausea or vomiting
• inability to maintain fluid intake
• severe constipation.

Pain after surgery

Some pain is to be expected but it should be manageable. For mild pain you will be prescribed paracetamol and non-steroidal anti-inflammatories (NSAIDS) like diclofenac and ibuprofen. For moderate pain, a weak opioid will be added in e.g., codeine, tramadol in addition to paracetamol and NSAIDs.

Severe pain requires a change to a strong opioid in addition to paracetamol and NSAIDs e.g., morphine, oxycodone.

If opioids are needed, they are only prescribed for short-term because they have many side effects – nausea, vomiting, constipation, drowsiness, dizziness, itchy skin and they can increase the risk of falls in the elderly.

Post-Operative Nausea and Vomiting (PONV)

Some patients experience PONV after surgery. It is more likely if you are female, a non-smoker, your surgery lasted over an hour, you have experienced PONV before, you have a history of motion sickness or are taking opioids for pain. Oral anti-nausea medicines can be prescribed or an anti-nausea patch can be worn behind the ear and changed every three days.

Constipation

Immobility, diet changes, dehydration and opioid pain medicines all contribute to the bowel slowing down and causing constipation. If opioids have been prescribed for pain you will also be prescribed a laxative. Other ways to prevent constipation is by adding dietary fibre (kiwifruit, prunes, psyillium husk), staying hydrated and getting mobile as soon as possible.

Exercise and diet

Good nutrition helps with wound healing, as does exercise. It is important to try and return to your usual amount of physical activity as quickly as possible, although the level of ability and activity will depend on your type of surgery. Your surgeon will let you know of any restrictions on exercise or movement, which activities to avoid and which ones to take care with. You may need the “all clear” from your surgeon before resuming certain activities.

After surgery your body and mind need time to rest and recover. Follow the instructions from your health care team and take your pain relief as prescribed. Above all, be aware of any changes to your wound or overall health that may need urgent care.