What is post abdominal surgery care?

The day of your operation is critical to treat your condition.  But equally as important is your recovery from major abdominal or pelvic surgery.  Dr. Maher Abbas will provide you with world class surgical expertise.  He is committed to guiding your recovery in order to achieve a superior outcome.   The majority of patients have an uneventful steady recovery but on occasions a few bumps may be encountered during your healing journey.  The following instructions are helpful to guide your postoperative journey.  If these instructions need to be customized to you, Dr. Maher Abbas and his team will discuss them with you.

Activity

By the time you leave the hospital you should be able to take short walks.  The first couple of weeks you will often feel like resting and taking naps because of low energy level.  Your body needs time to heal.  No vigorous physical activity (such as aerobic exercise, bicycle riding, jogging, weight lifting) for 4 weeks after laparoscopic camera surgery and 6 weeks after open traditional surgery.  If you need to cough, always support the abdomen with a pillow.  If you are provided with an abdominal binder (a supportive wide belt), you are encouraged to wear it during daytime when you are active.  An abdominal binder provides comfort and support and for some patients it decreases the risk of hernia formation.  Do not drive while you are taking pain medications.

Diet

By the time of your discharge, you will either be on a full liquid or soft diet.  If you had bowel resection (portion of the intestine or colon removed), stay on a low fiber diet for the first 2 weeks then you can resume your usual diet unless instructed otherwise [see section on Post Surgery Diet].  If you have a colostomy or ileostomy bag, follow the instructions in the sections on Colostomy Care and Ileostomy Care.  Most patients can lose on average 5 to 8 kilograms after major abdominal and pelvic surgery.  Do not get alarmed and often the weight is regained within a period of 6 months.

Medications

You can resume your home medications unless instructed otherwise.  If you are on any blood thinner, ask Dr. Maher Abbas for specific instructions.  Take pain medications and other medications as prescribed.  If mild ache or discomfort, you can take 1 to 2 tablets of Tylenol [paracetamol 500 mg] every six hours as needed [can take up to 6 tablets per day].  If you are prescribed a non-steroidal anti-inflammatory medication (NSAID) such as Voltaren, Advil, Aleve, Ibuprofen, always take it with food.  Do not exceed the prescribed dose or frequency.  Sometimes you will be prescribed an anti-acid medication to protect your stomach (such as Gaviscon, Zantac, Pepcid, Tagamet, Nexium, Prilosec, Pantazol). If another type of pain medication is prescribed, Dr. Maher Abbas or his nurse will give you the proper instructions.  Drink plenty of water with medications.

Sexual Activity

If you are sexually active, ask Dr. Maher Abbas to clarify when you can resume sexual activity.

Signs to watch for

If any of the following symptoms occurs, immediately notify the office during regular working hours and seek emergency room care or come to the clinic as instructed.   After hours, you can reach Dr. Maher Abbas and/or his nurse directly through cell phone or WhatsApp or come immediately to the emergency room to get triaged if unable to reach them.  The following are the symptoms to watch for:

• Blood in the urine, dark urine, or painful urination
• Continuous bleeding from the anus or passage of multiple blood clots
• Diarrhea or loose stools that do not improve as you advance your diet
• Excessive pus drainage (milky thick smelly secretions) from the anus
• Pelvic pain that radiates to the back, legs, or rectum
• Persistent nausea, vomiting, or inability to take oral hydration
• Recurrent fever (Temperature >38 ° Celsius, >100.4 ° Fahrenheit)
• Redness or thick drainage from the wound
• Severe abdominal pain with distention and cramping
• Shortness of breath, chest pain, or racing heart beats (palpitations)
• Swelling in the legs

Surgical Drain

• • If you are discharged with a surgical drain (a plastic tube) [Figure 1], see the section on Surgical Drain Care. On rare occasions following pelvic surgery (such as operations performed for rectal cancer or for complex fistulas with the bladder, prostate, or vagina), you may leave the hospital with a urinary catheter in the bladder.  You will be provided with the appropriate instructions to care for the catheter which is often removed at the 1^st follow-up appointment unless healing confirmation is needed through a radiologic X-RAY study.

Figure 1- Surgical Drain

Time Off Work

Depending on the type of your operation and nature of your employment, you will need 2 to 4 weeks off work.   Dr. Maher Abbas and his team will provide you with the appropriate sick leave certificate.

Wound Care

Proper wound care is an essential part of your recovery.  Unless instructed otherwise, follow the following instructions:

1. You can shower starting 48 hours after your operation but no scrubbing or soaking of the abdominal wounds in a tub

2. After the initial dressing from the operating room is removed, you can leave the wound open to air unless there is drainage or you feel more comfortable with soft gauze covering the wound. If you have small skin tape (steri-strips) on the wound, you can peel off once the edges start coming off – usually about 10 to 14 days from the day of surgery

3. For a straight forward recovery, there is no need to apply any medication, solution, or ointment to the wound. Occasionally during your recovery, the wound may get itchy.  A gentle application of a moisturizing lotion or creams such Vitamin E, Aloe Vera, or olive oil ointment can be helpful. If you have an open wound, you will be provided with the proper instructions.

Follow-up appointment

Usually a routine follow-up visit will be arranged within 5 to 10 days of discharge from the hospital.  Additional follow-up visits are arranged based on your needs.  However, should you have a concern about your recovery, you can call the office at any time.  If biopsies or a specimen were taken, the results will become available within 1 to 2 weeks of your operation.

Any questions?  Contact Dr.  Maher A. Abbas’ office nurse here.