Post Operative Instructions to Patients

This information sheet has been prepared to assist you in understanding how to look after your surgical incisions in the post operative period. Many of the common questions that patients ask have been answered below. This will help you to understand what to do and the limitations that you should observe, to attain the optimal result from your surgery. It is important that you read this information carefully and completely.

What to do Immediately After the Procedure

For “day cases” performed under either local anaesthesia, conscious sedation or general anaesthesia, you may have something to eat or drink when you return to the ward from recovery. If you are medically stable and feeling well you may discharged after one hour. You will be considered legally incompetent for 24 hours after the procedure – please ensure that a responsible adult is available to assist you. You may not drive yourself home after the procedure.

For “overnight cases”, usually performed under general anaesthesia, you may have something to eat or drink when you feel well enough to do so. Occasionally post-anaesthesia nausea may persist for several hours afterwards. You will be prescribed medication for this, but these medications may not be fully effective in all cases. You will keep the intra-venous access line (“drip”) in for the night, both for medications and extra fluids.

Post-Operative Appointments

Unless you have already confirmed your post-operative appointment, please call my rooms on the day of discharge to schedule your follow up appointment for approximately one week after surgery, unless I specifically instruct you otherwise. The office phone number is +27 11 356 6205.

Post-Operative Medication (Pain Control and Antibiotics)

In many cases I perform additional local anaesthesia (nerve block) to assist with post-operative pain control. You will also be provided with a prescription for additional pain medication. It is very important to take your pain medication regularly and before the pain becomes unmanageable. In this way, the medication is more effective and smaller overall doses are required. Do not be overly concerned about the exact dosing schedule as long as you do not exceed the daily recommended maximal dose. Take your medication whenever you feel you need it. A constant “burning” pain which manifests after 2 weeks is NOT normal and may require additional treatment – please contact the office if you experience this.

If I prescribe antibiotics, it is very important to take them exactly as prescribed and to finish the course. In some female patients, thrush (Candida infection) is a common complaint after taking a course of antibiotics. Please contact the office as a very effective treatment is available on prescription.

Wound Healing

After 5-7 days, the enzymes of wound healing are very active in the deep layers, preparing the wound for building new collagen. The wound is at its weakest at this point but pain becomes less severe. This makes this period dangerous, as patients tend to overexert themselves. Please exercise extra caution with movement during this time. Thereafter, occasional pain (which is typically described as “stabbing or piercing” in nature) is very common and can be considered a normal part of wound healing. “Buzzing” or “electric shock” sensations are also common and they too, can be considered a normal part of the healing process. These sensations generally subside within 6 weeks. By 3 weeks, new tissue is being laid down very actively by the cells within the wound and this period is very critical to a good result. Even though new tissue is being laid down, the overall wound strength is still only 10-20% of the final strength. Due caution should still be maintained. By the end of the 6 week period, the wound strength approaches 90% of the final strength and you may increase your activity level appropriately.

Post-Operative Wound Care & Scar Management

In cases where a surgical drain is used you will be given specific instructions about this. The drain usually remains in until drainage has declined to an acceptable volume. This may be anywhere from 1 day to 3 weeks. Surgical wound care is a shared responsibility between the patient and the medical staff. Unless you receive specific instructions, the following management protocol is my usual recommendation, and should be followed unless I give specific instructions otherwise.

Further Surgery

Unless specifically indicated, it is generally unwise to perform any surgery to the same area for a period of at least 12 weeks. Moreover, for scar revision specifically, it is usually better to wait for 6 months or even 12 months before surgically revising a scar. In certain cases, up to 24 months may even be applicable.