Open Abdominal Surgery (Spine, Gastric, Pancreas, Liver or Colon)

Post-Operative Instructions

Open abdominal surgeries do involve a hospital stay. If you had general anesthesia, you may feel drowsy or nauseated for a temporary period of time that may last 12 to 24 hours.

Incision Care

Some pain, bruising and minimal amount of a “Kool-Aid” looking discharge is expected and anticipated. If you notice any major swelling, bleeding or severe discomfort after surgery, notify the hospital staff, or if at home, go to the emergency room.

Your abdominal wound may be covered by a gauze dressing. You may remove your gauze dressing and shower on the second morning (48 hours) after your surgery date. You will likely have small pieces of tape (steri-strips) over your incision. These will naturally fall off over time, do not manually remove them. You may also have staples, which can be left uncovered. They may be irritating to the skin and cause redness. If this persists or enlarges, dab the area with rubbing alcohol using cotton balls twice a day.

Following abdominal surgery, it is not unusual for the abdominal wound to drain some clear fluid. This is very common for patients who are overweight. Do not be alarmed. It is safe to take a shower. Apply dry gauze to the abdominal wound. If you notice skin separation at this site, cover the area with dry gauze and notify the office. It is crucial to notify your surgeon or go to the emergency room if you notice any unusual intra-abdominal organs protruding through your incision. This is a surgical emergency.

It is necessary for you to continue to wear your abdominal binder as advised. Usual recommended time is anywhere from 4-6 weeks. You may take off the binder at night when resting in bed.

Diet

If you had open spine surgery, you may resume your regular diet as tolerated. Stay hydrated and add fruits and vegetables (fiber) to help prevent constipation. If you had pancreatic or liver surgery, you were likely recommended a low fat diet until seen in follow-up in the office. Avoid greasy, fried foods and anything containing a lot of oil.

If you had colon surgery, you should initially start with low fiber (avoid solid fruit and vegetables and nuts/seeds) to allow things to pass gently through the colon. After your follow-up appointment you will likely be transitioned to a higher fiber diet again.

Medication

Please be sure to take all medications that you usually take on a regular basis. However, it would be a good idea to avoid aspirin, Motrin or Advil for five days after your operation, unless prescribed or recommended by your surgeon.

Pain medication will be prescribed for you; you may take it as needed. You should avoid driving, operating heavy equipment, or potentially hazardous garden equipment while taking narcotics. Side effects of narcotics may include nausea, vomiting, lightheadedness, rash, irritability, or fatigue. Once pain begins to subside, you may try switching to some plain Tylenol after the first day or two since you may no longer need the narcotic. This will help avoid constipation as well.

You should also take a stool softener if prescribed by your surgeon. You may have a gentle laxative, such as 1-3 tablespoons of Milk of Magnesia if you have not had a bowel movement for three days.

Activity

You are to avoid heavy lifting in the first 4 weeks—no greater than 10 pounds. Some bruising or black and blue areas around the surgical site are not unusual and will resolve over the next few days.

Activities such as deep breathing, walking and going up the stairs will encourage the resolution of some of the stiffness and discomfort and is highly recommended. Many people have problems sleeping after an operation. This is usually the result of too many naps during the daytime. Adequate activity should resolve this problem.

Resumption of driving is dependent on the type of procedure you have had and your level of pain and mobility—generally a few days to up to two weeks after surgery. After major abdominal surgery, it is recommended you wait until your first post-operative visit to the surgeon before initiating any driving. As always, wait to drive until common sense says it is safe to do so. You must no longer be taking narcotics, and must be able to respond physically and cognitively to any situation on the road you may encounter.

Call the Office at (815) 717-8730

• When you return home from surgery to schedule a follow-up appointment to take place 10-14 days after surgery date.
• If you have bleeding from the surgical site that requires more than two maxi-pad dressing changes.
• You are still unable to have a bowel movement after trying Milk of Magnesia on the fourth day following surgery.
• You develop a fever of 101°F or 38.5°C or higher following the day of surgery. However, low-grade fevers are not unusual after abdominal surgery and should be managed with coughing, deep breathing and walking. You may use over-the-counter Tylenol (650 mg every 6 hours as needed).
• If you have any other problems or concerns.

Go to the Emergency Room:

• If you have been unable to urinate six to eight hours after being discharged from your surgery and have a feeling of fullness, let the tap water run to instigate urination. If you are still unable to urinate, go to the emergency room.
• If you notice any unusual intra-abdominal organs protruding through your incision.
• If you have serious problems and are unable to reach your surgeon or office staff.