information about caring for your wound, pain medication and physical activity after your surgery.
Wound carePain medicationActivity
- Please refer first to your discharge paperwork. If you have been placed in a splint, you should leave this on until seen for your first postoperative visit, unless otherwise specified in your discharge paperwork. If you have a standard dressing on, you should leave the dressing on for a minimum of 3 days. You need to keep the incision clean and dry for a minimum of 3 days after your operation. Sponge bath or cover the incision with waterproof bandage. Keep your incision covered with a dressing until there is no discharge on bandage. Once the incision is dry with no discharge, you may leave it uncovered, open to air.
- If you have steri-strips (paper tape) over your incision, keep the incision covered until there is not discharge on bandage. Gauze and tape are the main supplies you will need for dressing changes. The steri-strips will fall off on their own. Trim edges of the steri-strips if they start to peel up.
- When you shower, let water run over wound. Pat dry. Do not scrub or soak wound in water (pool, hot tub, bath) until the incision is sealed (usually 3-4 weeks)
- Avoid using lotions, powders, oils, or ointments on your incision until there are no scabs or blistered areas.
- In some cases you will be sent home with a 'Prevena' single use negative pressure wound therapy system that is applied to the incision to improve healing and prevent dehiscence. You will need to cover it when showering. The therapy unit will automatically time out after 7 days of cumulative run. You will be alerted with a beep until it shuts itself down. Starting at the top of the dressing, gently stretch the dressing border to release the adhesive and remove the dressing following the directional line of the incision. You may discard the entire dressing including the cartridge. You can apply clean dressing as needed after removal of 'Prevena'. If there is no drainage from the wound, you may leave the incision open to air. Please contact our office if you notice any redness surrounding the wound or persistent drainage after removal of the 'Prevena'.
- If you have any concerns with your wound healing or if you are worried about an infection you can send a photo of the area via MyChart. If you have not signed up for a MyChart account you can contact our office at 503-418-9030.
- You will be discharged with a prescription for narcotic pain medication following your surgery. The type of medication will be determined during your hospitalization. Please follow the administration directions as prescribed. If you are having issues controlling your pain please call the orthopedic clinic, at 503-418-9030. Narcotics have addictive potential so utilize over the counter pain medication to supplement the narcotics so you are able to wean off them as quickly as your pain allows.
- Please remember that the purpose of pain medication is to decrease the amount of pain you are experiencing, not to eliminate your pain.
- If you need a refill, please call the orthopedic clinic on business days between 8 am and 4 pm. Please allow 48-72 hours for refills to be processed.
- On-call (after hours) doctors are not permitted to prescribe narcotic pain medications. Prescriptions will not be available through our office on weekends or holidays.
- On the day of surgery, the anesthesiologists may suggest a nerve block for pain control. They will answer all questions in regards to this in the pre op holding area.
- NSAIDs can be very effective for postoperative pain. They can typically be resumed immediately after surgery, unless otherwise specified in your discharge paperwork, even if you are put on Aspirin daily for DVT prophylaxis. Recommended dose for Advil (ibuprofen) is three 200 mg tabs 3 times per day as needed for pain. Aleve (naproxen) is an alternative to ibuprofen and can be taken as two 220 mg tabs twice a day as needed for pain. You should not take Aleve and Advil together, but you may take either in addition to Tylenol and your narcotic pain medication. NSAIDs can be hard on your stomach, so they should be taken after eating something. You should avoid NSAIDs if you are on an injectable blood thinner or if you take medications such as Warfarin or Plavix.
- Tylenol (Acetaminophen) is a good supplement to narcotic pain medication. Although it may not control your pain alone, it can lessen you need for narcotic and decrease narcotic associated side effects like constipation and nausea. As long as you do not have liver issues, you may take up to 3000mg of Tylenol per day in the postoperative period. DO NOT TAKE TYLENOL IF YOU ARE TAKING VICODIN, NORCO OR ANY COLD/FLU PRODUCTS. THESE MEDICATIONS ALREADY CONTAIN TYLENOL
- Constipation is a side effect of all narcotic pain medication. You may be discharged on a stool softener, and may take this until you are done taking narcotic pain medication. You may purchase a stool softener over the counter if you were not prescribed one. Senna and Colace are the recommended stool softeners. If you are having issues with constipation, while taking the stool softener, you may add Miralax, Magnesium Citrate or Milk of Magnesia. These are laxatives which are available over the counter.
- Please refer to you discharge paperwork for your specific activity restrictions. It is important that you comply with these restrictions until we progress your activity to allow for proper healing
- If you are given home exercise, please continue these until your post op appointment.
Questions and concerns
Please call our clinic with any questions/concerns or if you experience any of the following
- Excessive bleeding, drainage, redness, swelling at the operative site
- Drainage from the wound persisting beyond 1 week from surgery
- Persistent, localized swelling that does not improve with elevation of if you have any persistent calf pain, shortness of breath, difficulty breathing or chest pain.
- Fevers (>100.5) or persistent nausea or vomiting.
503-418-9030 during business hours (8:00am-5:00pm)
503-494-8311 after hours and ask for the orthopedic surgery resident on call
Follow up appointments
- Most patients are scheduled for a postoperative evaluation 1-2 weeks after surgery to ensure the wound is healing well, discuss any concerns and to discuss pathology results. Our policy is to not release pathology results over the phone or MyChart as we prefer to discuss the results face to face. We do occasionally make exceptions, but this should be determined preoperatively. Call your Primary Care Physician as needed for your concerns not related to your surgery.
- MyChart is an excellent tool to allow improved access to your health record as well as your healthcare team. You can also send photos of your incision if you have any concerns with wound healing or if you are worried about an infection.