What If I Have A Question After Surgery Whom Should I Call
We have two nurses and two administrative assistants who are available to help you before and after surgery to answer any of your questions or concerns. Ideally, we recommend that you call us at 708-236-2738 during normal business hours to have your questions answered by someone who knows Dr. Della Valles protocols and knows you as a patient! While other care providers are available 24hours per day and 7 days per week, we again strongly recommend calling us during normal business hours.
I Continue With Physical Therapy
I started offsite therapy three days a week on the third-week post surgery. The first week I was introduced to new exercises including the stationary bike and the Total Gym.
It was easy going at first. I started out on the stationary bike as a warm-up for 5 minutes before moving to the Total Gym for 5 minutes of leg presses.
After those exercises, I would get a short massage and work on my range of motion exercises.
At 2 months, I am warming up with 10 minutes on a stationary bike . The load has increased on the Total Gym with more leg presses.
I am doing wall squats, stretches using bands, and an exercise ball for ankle slides. At least once a week the therapist measures my range of motion.
All of my offsite therapy sessions end in 10 minutes of icing. I continue to ice my knee at home after any activity.
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Where Is The Best Placement Of Grab Bars In The Tub/shower
For placing grab bars in your bath tub or bathtub shower combination, use these guidelines:
- A vertical entrance/exit grab bar is best placed on the wall opposite the faucet.
- Mount a horizontal grab bar on the sidewall between 33 and 36 inches above the floor. It should be as long as possible.
- The faucet wall requires a vertical grab bar situated close to the faucet controls.
- Never soak the bandage of a new knee replacement, such as taking a bath.
- Avoid direct shower spray onto the surgical bandage.
- Wrap the bandage with Saran Wrap if there is any question about its water resistance.
- Pat the bandage dry after showering. Rubbing the bandage with a towel may break the water-resistant barrier.
- Set up the showering area and dressing area with all necessary items before beginning the shower.
- Be sure to use a non-skid mat in a tub shower.
- Serious consideration should be given regarding the installation of grab bars before the surgical date.
Enjoy Your Showers Safely
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How Do I Care For My Dressing After Surgery Can I Shower After Surgery
At the time of surgery, a waterproof bandage will be placed on your incision and you can shower right after surgery. This special bandage has been shown to decrease the risk of wound healing problems and infection after surgery by providing an optimal environment for wound healing. If you have leakage from around the bandage or you has questions or concerns about the dressing or your wound, please call our office immediately.
This dressing stays in place for one week and then must be changed. You can purchase a replacement dressing for the second week after surgery in our Durable Medical Equipment store. We recommend purchasing this either on the day of your teaching class or to have a family member or friend get one for you before you leave the hospital. Just let the people at the store know you are my patient and they will help you pick out the right bandage.
If you do not purchase this bandage, a dry dressing can be placed over the incision for one more week, however you cannot get it wet.
At two weeks after surgery, you can leave the incision open to air and you can shower, but not submerge the incision. The incision can be submerged in a pool or bath at approximately 3-4 weeks after surgery, once it is fully healed with no scabbing present.
After You Get Your Stitches Removed You May Get Your Incision Site Wet When You Shower
If your stitches are DISSOLVABLE, they will disappear on their own in about 3 weeks. If you are not sure about what kind of stitches you have, ask your health care provider.
If your stitches are not dissolvable, check in with your health care provider to get them removed when it is time – usually this is 14 days after surgery.
After the stitches are removed, make sure you PAT DRY the incision site for optimal healing. Keeping the operated site wet may increase the risk of infection. Rubbing the skin around your incision can irritate the site so avoid doing this.
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Assessment Of Methodological Quality
Two reviewers independently determined the method quality regarding bias in the selected studies . Methods included in the bias assessment were random sequence generation, allocation sequence concealment, blinding of participants and outcome assessors, incomplete outcome data, reporting bias, and other bias. Subsequently, each item was scored as yes , unclear , or no . Discrepancies were then cross-checked and resolved by a third reviewer , of which only then was a final consensus reached. A risk-of-bias summary and risk-of-bias graph was then generated using Review Manager 5.3.0 software .
Caring For Your Incision After Surgery
When youre recovering from surgery, the last thing you want is a problem with your incision. An incision is the cut or wound from a surgery. It is sewn closed by your doctor. It may also be stapled, taped, or glued closed. With proper care, it turns into a scar. Taking care of your incision after surgery is important to your health. Proper care can reduce the risk of infection and help you return to normal sooner. Incisions vary by size and location.
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Description Of The Condition
Most surgical procedures involve a cut in the skin that allows the surgeon to gain access to the deeper tissues or organs. Most surgical wounds are closed fully at the end of the procedure.This is called primary closure . The various techniques for wound closure include closure using sutures, staples, adhesive tapes and tissue glue . Primary closure is essential to restore the skin barrier, which prevents infection of deeper tissues. However, it is not always possible to maintain clean conditions throughout surgery, for example, when operating on a contaminated wound or when operating on tissues that contain contaminated material . In these situations it is sometimes best to delay closure of the wound until the wound develops good granulation tissue, and this is called secondary closure .
Wash Your Hands A Third Time
Before you begin applying a new bandage, wash your hands again.
Another round of washing your hands helps prevent any material that was cleansed from the incision from being reintroduced into the area. This is especially important if an incision is showing any signs of infection.
If you are assisting someone, put on a new pair of gloves before moving on.
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When Can I Shower After Knee Replacement Surgery
A total knee replacement patient can shower the day after surgery if the surgical site is protected from becoming wet by using a water-resistant bandage or wrapping the knee with Saran Wrap and duct tape to keep the water out, and the showering station is safe from slip and falls.
Each surgeon has their own protocol and timeline therefore, it is best to check with your surgeon on how soon you may take a shower.
Keeping the total knee surgical site bandage clean and dry is the patients number one focus until the bandage is removed.
According to a research paper in the US National Library of Medicine, infection is the biggest risk factor the patient faces, and keeping the bandage clean and dry is the best practice a total knee patient can do to prevent a devastating knee infection.
The majority of the patients I see come from a surgeon that has the lowest infection rate in California. He uses biological glue to close the surgical site, covering the surgical site with a Mepilex/Optifoam water-resistant bandage that is removed on the 7th day with the surgery day being counted as day one.
His patients do not require any secondary Saran Wrap techniques to prevent the bandage from becoming wet unless the water-resistant seal is broken, in which case the bandage is replaced, or protected from shower water using the Saran Wrap technique.
There is a correct way and an incorrect way to apply the Saran Wrap extra protection layer:
When To Call Your Surgeon
- a temperature of 101.6 F or higher
- a sudden increase in drainage, draining lasting more than five days after your surgery, or drainage that is yellow in color or foul-smelling
- severe discomfort, fatigue or pain
- severe swelling that does not improve each day
- blisters around your incision
- any change in movement such as new weakness, firmness in your calf muscle or inability to move as usual
- any questions or concerns
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Welcome To Dr Frischs Blog
Dr. Frisch is committed to educating his patients on the latest information and technology in orthopedic care. Check out his blog to learn about the latest trends in healthcare.
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One of the questions on the minds of hip or knee replacement surgery patients is how to manage their post surgical dressing. Keeping the incision site clean and protecting it from infection is important for achieving a successful surgical outcome. Heres how to care for your incision and look after your dressing after your surgery.
Multiple different layers of sutures are used to close the surgical incision. A surgical mesh and glue is then placed on top of the incision and a waterproof dressing is placed on top of it. The surgical dressing needs to remain in place for one week. During this time, you may shower but have no baths. After showering you must gently pat the dressing dry.
You can remove the surgical dressing yourself after one week. Start from one corner of the dressing and begin to slowly peel it off. After partially removing the dressing, you should be able to see the surgical mesh underneath. Place one finger on the mesh to hold it in place and continue to peel off the dressing in line with the incision.
If your surgical dressing or mesh gets displaced earlier than the times mentioned above, you should call our office for further instructions. In some instances, you may need to return to the office for a re-application of the dressing.
Activity Restrictions After Knee Replacement Surgery
Patients are typically given a list of activities they should not do, also called precautions. Common restrictions during this phase of recovery include:
- No driving. Pain medications, pain, stiffness, and other factors will affect a persons ability to operate a motor vehicle.
- No swimming or taking baths. Immersing the wound in water increases the risk of infection.
- No carrying heavy loads. The extra weight will put added stress on the new knee.
Patients should adhere to the all activity restrictions assigned by their surgeons office.
See Post-Surgical Knee Replacement Precautions and Tips
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Do Not Get The Dressing On Your Knee Wet If Your Dressing Is Not Waterproof
After coming back from the hospital, you are probably in so much pain that the last thing you think about is taking a shower. If you do end up being sick of marinating in your own sweat, here is the catch: RESIST THE TEMPTATION TO TAKE A SHOWER. Dont get me wrong: we are not advocating bad hygiene here. Before your health care provider says its okay to remove your dressing , you should clean yourself with a damp washcloth instead. You may shower again after your dressing is removed.
How The Intervention Might Work
Dressings can act as a physical barrier to protect wounds until the continuity of the skin has been achieved this occurs within about 48 hours of surgery and to absorb exudate from the wound, keeping it dry and clean with the aim of avoiding bacterial contamination from the external environment . Another reason for using a dressing is to prevent contamination of the surrounding area by any wound discharge , although this is mainly applicable for cleancontaminated, contaminated, and dirty or infected wounds. Some studies have found that the moist environment created by some dressings accelerates wound healing , although others believe that it is a disadvantage, as excessive exudate can cause maceration of the wound and the surrounding healthy tissue . Ideally surgeons choose suitable dressings to ensure that the wound remains:
- free of clinical infection and excessive slough
- free of toxic chemicals, particles or fibres
- at the optimum temperature for healing
- undisturbed by the need for frequent changes
- at the optimum pH value.
As wound healing progresses, it may be appropriate to use different types of dressings .
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Do Not Soak Your Dressing Even If It’s Waterproof
You may wet your dressing lightly in a standing shower. However, at this point, its not recommended to take a bath. Depending on the manufacturer, your waterproof dressing may become detached when submerged in water. If you are not sure what kind of dressing you have, avoid getting it wet altogether.
Wearing Compression Socks After Surgery Promotes Circulation
Surgical patients have two competing needs after their procedures. It is important to keep the incision site stable to avoid disturbing stitches. But it is also important to keep blood flowing even when it is not possible to flex major muscles. Graduated compression after surgery can keep blood flowing by applying gentle, tapering pressure on your legs. This increases circulation even when patients are restricted to bed rest.
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Pain After Total Knee Replacement
You will experience some postsurgical pain in the area that has been operated on after your knee replacement. This is normal and you will be prescribed medications by your surgeon to attempt to control your pain and bring it within tolerable levels. It is important to remember that, at this stage, it is unrealistic to expect that there will be no pain and so a small amount of soreness in and around the knee is normal. It will take one to two weeks for the postsurgical pain to dissipate however, this does not indicate that the knee has fully healed.
There will be some discomfort in the knee up to around 6 weeks following the surgery and in some patients, this may even persist up to 3 months following the surgery. The pain is caused by a number of factors including the muscles around the knee recovering from the surgery and regaining strength that they have lost as a result of the surgery, as well as other tissues around the knee healing and getting used to the new biomechanics of the knee joint.
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When To Call A Healthcare Provider
If your Steri-Strips come off and the incision opens, see your healthcare provider right away.
Reclosing an opened incision can be challenging and, if not done correctly, may result in “second intention,” a condition in which the open gap will fill in unevenly while healing and cause an unsightly scar. Worse yet, it can lead to an infection.
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Common Symptoms After Surgery
Your incision will be swollen, bruised and may be red after surgery. These symptoms are common and part of the healing process. The following symptoms are also common after surgery:
- temperature below 101.6 F
- warmth or numbness around your incision
- spotty drainage, red or clear in color, lasting for one to five days
It is important to monitor your symptoms every day to make sure your incision is healing properly.
What Does The Evidence Show
A study published in 2014 examined the long-term effects of using a knee brace after ACL surgery versus using no brace at all. The researchers randomized 64 patients who had ACL surgery into two groups. One group used a brace after surgery, and the other group did not use a post-operative brace after their ACL surgery.
Four years after surgery, the researchers measured ACL ligament integrity, pain levels, and X-ray pictures in 52 of the original patients.
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When Do I Take Off The Bandage
Your doctor will give you exact instructions on when and how to change it. Most wounds don’t need one after a few days, but if you keep the area covered, it may help protect the cut from injury and it may heal faster.
If you do keep a bandage on, change it every day. Wash your hands well with soap and water before and after.
Can I Shower After Surgery
At the time of surgery, a waterproof bandage will be placed on your incision and you can shower right after surgery. This special bandage has been shown to decrease the risk of wound healing problems and infection after surgery by providing an optimal environment for wound healing.
This dressing stays in place for one week and then must be changed. You can purchase a replacement dressing for the second week after surgery in our Durable Medical Equipment store. We recommend purchasing this either on the day of your teaching class or to have a family member or friend get one for you before you leave the hospital. Just let the people at the store know you are my patient and they will help you pick out the right bandage.
If you do not purchase this bandage, a dry dressing can be placed over the incision for one more week, however you cannot get it wet.
At two weeks after surgery, you can leave the incision open to air and you can shower, but not submerge the incision. The incision can be submerged in a pool or bath at approximately 3-4 weeks after surgery, once it is fully healed with no scabbing present.
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