General Abdominal Surgery Post-Surgery Guide

The following information is intended to guide you through your post-op recovery.

Diet:

  • For the first few days after surgery, eat foods that you easily tolerate normally.

Medications/pain management:

  • Follow the directions on any new prescriptions that your doctor has given you. Prior to your discharge, you will learn which daily medications you need to take when you return home.
  • Pain management is an important part of your post-surgery care, and you should expect some discomfort after surgery. You may be sent home with a prescription for pain medication. It is important to take your pain medicine prior to your pain becoming intense in severity.
  • PLEASE NOTE: No pain medication refills will be authorized on the weekends. If a refill is needed, the request must be made BEFORE 12:00 PM (noon) on Friday.
  • Some side-effects from narcotic pain medication include nausea/vomiting and constipation. If you experience nausea/vomiting or constipation related to your pain medications, you should stop the medication and take ibuprofen or acetaminophen for pain management.

Bowel care:

  • While on narcotic pain medications, you should be taking Colace 100mg twice daily. If you do not have a bowel movement after 3 days, take Milk of Magnesia: one dose every 8 hours for 3 doses. If that does not work, call our office for other suggestions. You should also walk or move about as much as you are able. Drink 8 glasses of water per day to help facilitate bowel movements. If you experience watery, foul, frequent diarrhea, call our office for further evaluation.

Dressing/incision care:

  • If you have a gauze/fabric dressing, please leave your dressing on for 2 days after surgery. After the second day, you may remove your dressing and shower, by removing the outer dressing and leaving the strips of tape (steri-strips) that cover your incision.
  • If you have a plastic dressing, you may shower as normal with the dressing in place. Remove the plastic dressing 2 days after surgery, by removing the outer dressing and leaving the strips of tape (steri-strips) that cover your incision.
  • Steri-strips should remain in place for 10-14 days. The strips will gradually loosen and come off. If they do not come off within two weeks, you may remove them.
  • If your clothes irritate the incision or if you have some drainage, you may choose to leave a dry gauze dressing over your incision.
  • Inspect your incision daily for signs or symptoms of infection. These signs would include: increased swelling, redness, pain, or smelly wound drainage. It is normal to have some swelling and bruising around your incision. It is also normal to have a firm lump directly beneath your incision line. This will disappear within a couple of months.
  • If you have staples or stitches, they will usually be removed 1 week after your surgery. You will need to make an appointment to visit our office to have them removed.

Drain care (if applicable):

  • If you have a drain, leave the dressing in place and keep dry (sponge bath only). You will need to “strip” the tubing and record the output at least two times each day (morning and evening), or when the bulb is 1/3 full.
  • Strip the tubing: Stripping means that you use your fingers to squeeze along the length of the tubing to help prevent clots and maintain the flow of drainage.
    • Using one hand, firmly hold the tubing near the insertion site (close to your skin). This will prevent the drain from being pulled from your skin while you are stripping it.
    • Using your index finger and thumb of the other hand, squeeze the tubing below the first hand. Squeeze it firmly enough so that the tubing becomes flat.
    • As you are squeezing, slide your index finger and thumb down the tube toward the bulb. Then, release the tubing held by the hand closest to your body. Repeat.
    • Do not release the pressure you are creating in the tubing until you reach the bulb.
  • Record the output:
    • Wash your hands with soap and water.
    • Carefully remove the plug from the top of the bulb and gently squeeze all of the drainage into the measuring cup provided for you.
    • Record the date, time and amount of fluid each time you empty.
    • To re-create suction, squeeze the middle of the bulb and replace the plug.
    • Rinse the measuring cup and wash your hands with soap and water.
  • When your drain output is below 30ml in a 24-hour period (unless otherwise specified by your doctor), call the office to schedule an appointment to have the drain removed.

Bathing/showering:

  • If you have a drain in place, sponge bath only until your drain is removed.
  • If you have a plastic dressing, you may start showering 24 hours after surgery.
  • If you have a fabric dressing, you may shower after you remove the dressing (4 days after surgery).
  • You may shower with your steri-strips and staples or stiches in place. Do not scrub across your steri-strips or staples.
    Do not bathe in a tub for 14 days after your surgery. This includes a hot-tub.

Driving:

  • You may drive when you are no longer taking narcotic pain medication AND you feel you can quickly respond to situations, while not placing others in jeopardy.

Physical activity/restrictions and return to work:

  • Upon your return home, minimize your activity level for the first 24 hours. Going to the bathroom is enough activity for the day. You should then begin a daily walking program that will gradually increase. Start by walking inside your home initially, and then gradually increase to walking around your neighborhood. Every patient needs to estimate the right the amount of walking time, according to their general status.
  • No lifting more than 10 lbs for 6-8 weeks post-op.
  • You may resume sexual activity when it is comfortable.
  • Your doctor should inform you of when you might return to work. Please notify our office if you need a return to work letter for your employer. It may take up to 48 hours for the letter to be completed. Please provide us a fax number for your employer, so we can fax your release.
  • The following will serve as a guide for when you might return to work or school:
    • Light lifting or no lifting jobs: You may return 2 weeks post-op with a weight-lifting restriction of 10 lbs.
    • Heavy lifting or physical type jobs: You may return to this type of activity 8 weeks after surgery.
  • Usually you can begin to gradually increase your activity 4-6 weeks after surgery. Recurrent hernia repairs may require longer; you may choose to discuss this further with your surgeon.

Follow-up appointments:

  • If you DO NOT have a drain, you will need to return to the office for a follow-up visit 2 weeks after surgery. Please call to schedule this appointment.
  • If you DO have a drain, call the office when the output is less than 30ml in a 24-hour period (unless otherwise specified) to schedule an appointment to have the drain removed.

Problems to watch for; call the office for the following:

  1. Fever greater than 101.0
  2. Uncontrolled pain. That is on a scale of 1-10 (10 being the worst pain imaginable) your pain is a level 7 or above.
  3. Nausea and/or vomiting that continues for 12-24 hours.
  4. Diarrhea that continues for 12-48 hours.
  5. Signs of a wound infection: increased swelling, redness, pain, fever or smelly wound drainage.
  6. Chest pain or difficulty breathing.
  7. Your incision separates or opens up.

Please call the office if you have further questions. Our office is open Monday – Friday, 9 am – 5 pm. After office hours, the answering service will be available to take your call: 541-868-9303.