Surgery: What to Expect

After Surgery

Postoperative risks

Your surgeon and the surgical team will keep you safe during your surgery. But surgery is never risk-free. Your surgeon will review all risks related to your surgery. The most common problems after surgery are pneumonia, bleeding, infection, clotted blood (hematoma) at the surgery site, or a reaction to the anesthesia.

In the first 48 hours after surgery, the most likely risks are bleeding or problems with your heart or lungs.

From 48 hours to 30 days after surgery, the most common risks are infection, blood clots, or problems with other body organs, such as a urinary tract infection.

In the recovery area

Right after surgery, you will be taken to a recovery area where nurses will care for and observe you. A nurse will check your vital signs and bandages. He or she will also ask about your pain level, which likely will have already been explained to you before surgery. You will most likely stay in the recovery area for 1 to 4 hours, and then you will be moved to a hospital room or you will go home. You may receive medicine or fluids through your vein (intravenous, or IV) during your time in the hospital.

If you go home, the nurse will give you instructions on breathing and exercises to help prevent any problems. For most minor surgeries, the nurse will encourage you to be as active as possible to prevent these problems.

Pain control is an important concern after surgery. Near the end of your surgery, your surgeon may inject a long-acting pain medicine at the site of your surgery to decrease your pain for 6 to 12 hours after surgery.

Relief of any nausea or vomiting is also an important concern. If you will be going home the same day, you will need to drink fluids without vomiting, be upright without fainting, and urinate on your own before you will be sent home.

Postoperative instructions

In addition to any special instructions from your surgeon, your nurse will explain information to help you in your recovery. You will most likely go home with a sheet of care instructions including who to contact if a problem arises. These instructions will include:

• Having someone else at home to check on you or arranging for a nurse to check on you.
• Which medicines you are to take and when, including medicines you take regularly.
• The level of activity that is safe for you to do. For example, the instructions will likely list when it is okay to drive, how much you can walk each day, how much weight you can lift, and what other things you can do as you recover. For most minor surgeries, you will be encouraged to be as active as possible to avoid problems.
• How to take care of your incision. The instructions will explain:
  • The best way to bathe and protect your wound, such as how to cover the area if needed and when it is safe to shower and let the incision get wet.
  • How to care for and change your surgical dressing.
  • What clothing to wear to avoid rubbing your incision area.
  • What symptoms to look for that may be a problem. Signs of a skin infection, such as a fever, increased pain, or increased drainage, need to be checked by your surgeon. Mild swelling and redness around the incision area is normal after surgery.
• What foods to eat and how your bowel and urinary habits may be different.
• The use of special equipment, such as a sling or crutches.
• When to have a follow-up appointment with your surgeon. Your surgeon will want to talk to you before your follow-up appointment if:
  • You are not sure about your home care instructions. Ask right away if you have any questions about wound care or drainage.
  • You develop a symptom or problem that you do not know how to handle.
  • You develop an unexpected symptom or problem.
  • You are not able to take your prescription medicines.

A nurse will review these instructions with you. He or she can also help arrange for any care you will need when you go home. This may include scheduling nursing care or visits from other health professionals.

When should I call my surgeon?

If you have any symptoms that require emergency treatment, call 911 or other emergency services immediately. The symptoms to watch for include:

• Signs of shock.
• Moderate to severe difficulty breathing.
• Severe pain.
• Shortness of breath with a rapid heartbeat. These may be symptoms of pulmonary embolism.
• Chest pain that is crushing or squeezing, is increasing in intensity, or occurs with any other symptoms of a heart attack.
• An increase in leg swelling. This may be a sign of deep venous thrombosis, a condition in which blood clots form that can be very serious if not treated.

Your recovery from surgery may be different from what your surgeon expected. Other symptoms or problems may develop after your surgery even when you follow your surgeon's instructions. This can be very frustrating.

Be sure to call your surgeon if you have an unexpected symptom or problem, including:

• Nausea and vomiting. If you are not able to keep fluids down, you may become dehydrated.
• Difficulty swallowing.
• Pain that does not go away when you take your pain medicine.
• A temperature higher than 101°F (38°C).
• Difficulty urinating or having a bowel movement.
• Loose stitches or an open surgical wound.
• Red streaks or pus draining from your wound.
• A rash.

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Author:	Caroline Rea, RN, BS, MS	Last Updated: March 27, 2008
Medical Review:	Anne C. Poinier, MD - Internal Medicine Brent Shoji, MD - General Surgery
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