Why after surgery? Prevention of complications after surgery and rehabilitation - intensive care, nursing care and observation

When can the suture be wetted after surgery? This question interests many patients. It must be said that the types of operations are very different, and so are the types of dressings. If your condition allows, then after about two days you can already take a shower. The most important thing is not to soak the seam. If a few drops get on it, it’s not a big deal. After washing, just dry the seam with a towel.

What to do if a bandage is applied

In this case, the patient should take a shower carefully; do not get it wet. There are several types of dressings, some of which are waterproof, but if you are unsure about this, you should exercise caution. The bandages should not be removed without the doctor's permission.

Maintaining good hygiene is essential to ensure proper wound healing.

To avoid the seam getting wet, do the following:

You need to cover the seam before washing. To do this, use bandages that are waterproof. You can use a rubber bandage or plastic bag to protect the seam.
In the first days after surgery, you should absolutely not take a bath. You can only swim in the shower.
There is no need to rub the seams with a washcloth.
Even if the seam is not wet, you need to blot it with a clean towel. This will prevent water from getting into the wound.
If the seams are wet, blot them and then treat them.

Caring for postoperative sutures is the same in most cases. For normal process healing, you need to regularly treat them with special skin antiseptics. This can be iodine, brilliant green, medium-strength potassium permanganate, hydrogen peroxide or furatsilin.
It is very important to adhere to the rules of hygiene and cleanliness.

All details should be obtained from your doctor. If there are no other instructions, then you need to know that you can shower and swim only one day after the operation. Only after a day should you carefully wash the wound warm water and soap.

After washing, the use of cosmetic lotions and creams is absolutely unacceptable. In some cases, the stitches are closed sterile dressings. Then you have to regularly visit the clinic and have dressings done. Or the doctor should give recommendations for dressing at home.

There are several types of materials that are applied to the seams. In addition, there may be several ways to apply a suture. Sometimes materials are used that dissolve over time. In other cases they are removed in medical office. It is extremely important to remove the sutures on the day prescribed by the doctor, neither earlier nor later.

If not only stitches were applied, but also staples, then only a doctor can remove them. Often, special tapes are applied to the surface of the seam, which fall off on their own after about a week. Often, if necessary, the suture is drained; the doctor should also instruct you on how to care for it in this case. You can remove the material used as drainage yourself.

It is very important to control your condition. If deterioration begins or body temperature rises, pain in the wound, swelling, hyperemia of the sutures, lumps and swellings appear, then you should immediately consult a doctor. Very often, in order to speed up wound healing, ointments containing antibiotics, for example, Levasin or Lvomekol, are prescribed.

If there is an inflammatory process in the wound, then you can apply a compress with dimexide. In addition, it is worth undergoing antibacterial therapy.

Depending on the type of operation, wounds begin to heal on average after 7-14 days. Scars lighten after about 4-5 months. Sometimes the use of ointments for accelerated healing scarring doesn't make sense. If the operation was serious, then you can take a shower only after 6 days.

Baths should not be taken until the wound has healed. Because there is a risk of infection in the wound.

If the healing process proceeds normally, then the wound does not require special treatment. If the wound heals well, then after two weeks you can take a bath. Influence warm water on the wound is undesirable, since this may cause undesirable processes in the scar.

After you have taken a shower, you should treat the seam with a 5% iodine solution or potassium permanganate. To improve wound healing, you can use products that contain panthenol. You can use sea buckthorn oil. But you need to consult a doctor. Contractubex has a good absorbing effect.

But you can use it after the wound has healed. It takes a very long time to use it. If the operation took place on abdominal cavity, then you should wear special supportive underwear. This will prevent the development of a hernia.
Maintaining hygiene is very important.

In addition to nutrition, many issues are related to behavior in everyday life after gall bladder surgery, the answers to which I collected for you, dear readers, in the comments to the articles. Perhaps they will help many of you overcome difficult period adapt and live normally and full life. How to live after gallbladder removal?

When can you start swimming in open water after surgery? Is it possible to sunbathe? Does water temperature matter?

It will be possible to swim in the sea and other open waters in a month, but it is necessary to avoid stress on the abs. You can actively swim no earlier than 6 months after surgery. The water temperature should be comfortable so as not to cause spastic contractions of the intestines.

For the first 6 months, it is not recommended to sunbathe on purpose; in addition, you should wear a closed swimsuit in the sun (persistent pigmentation may appear in the area postoperative sutures under the influence of the sun). You can only sunbathe for 6 months after surgery.

Tell me, how long after the operation can I go to the pool for swimming?

You can engage in active swimming in the pool six months after the operation. You can simply splash around in the pool without putting much strain on your abdominal muscles within a month after surgery.

Can I ride a bike or rollerblade after gallbladder removal surgery?

In a relaxed tourist mode, you can start riding a bicycle within a month after the operation. But active roller skating and cycling in sports mode is possible only 6 months after surgery, as the risk of the formation of postoperative ventral hernias is high.

Is it possible to exercise after removal of the gallbladder and what physical activity is acceptable?

It is possible and necessary to engage in physical exercise after removal of the gallbladder. In the first 6 months after surgery, it is advisable to avoid intense loads on the press As for the loads, after laparoscopic cholecystectomy in the first month of the postoperative period permissible load- lift no more than two kilograms of weights. After abdominal surgery in the first month - two kilograms, the second month - four kilograms. In both cases, intense stress on the abs should be avoided in the first six months.

6 months after surgery there are no special restrictions for reasonable physical activity not anymore. The only thing worth emphasizing is that professional sports not always good for health. Therefore, a very balanced approach is needed here.

When can I start ballroom and sports dancing?

It will be possible to practice ballroom dancing within a month after the operation, and sports dancing – after six months.

4 months have passed since my gallbladder was removed, is it still possible to do yoga?

During the first year of the postoperative period, you need to choose the mildest option. In the first 6 months, it is advisable to avoid intense stress on the abs.

Is it possible to be sexually active after surgery?

Within reasonable limits, you can begin to be sexually active within a week after surgery. For the first 1.5 months, it is advisable to avoid intense sexual intercourse.

When after surgery is it permissible to undergo sanatorium-resort treatment and is it possible to fly by plane?

Sanatorium - spa treatment perhaps three months after surgery. You can fly by plane.

Is it possible to take weight loss medications 4 months after gallbladder removal?

Special weight loss techniques can be practiced one year after surgery. It will be safe this way. In addition, it should be noted that strict adherence to diet No. 5, which is recommended for those who have had their gallbladder, usually leads to weight loss, and if you follow it, your weight problem will gradually go away.

3 months have passed since the operation. Can I do anti-cellulite massage and vacuum in the abdominal area?

You will have to wait another three months, when six months have passed since the operation.

2 months have passed since the operation, I feel good, can I go to the sauna?

Yes, you can, just be careful, don’t sit too long, focus on your own well-being.

These are the recommendations from Evgeniy Snegir and me for everyone who has undergone surgery to remove the gallbladder. And remember, the most important thing is yours positive thoughts, the attitude that everything will be fine. And, of course, it’s worth sticking to a diet, at least in the first year and a half after surgery. And such food can be tasty and varied. Health to everyone and joys of life.

Any surgery- a serious intervention in the body, and one should not expect that after it everything will be “the same as before.” Even if the surgeon who performed the operation is a real medical genius and everything went well, rehabilitation is necessary to restore the strength and functions of the body.

Rehabilitation after surgery: is it really necessary?

“Why do we need rehabilitation after surgery at all? Everything will heal, and the body will recover itself,” - this is, unfortunately, what many people in our country think. But it should be borne in mind that in a weakened body, the ability to self-heal is reduced. Some operations, in particular on the joints and spine, require mandatory recovery measures, otherwise there is a risk that the person will never return to to the usual way life. In addition, without rehabilitation after surgery, there is a high risk of developing complications caused by prolonged immobility. And not only physical ones - such as muscle atrophy and bedsores, as well as pneumonia caused stagnation- but also psychological. A person who until recently could move and take care of himself finds himself confined to a hospital bed. This is a very difficult situation, and the task of rehabilitation is to return to the person and wellness, and mental comfort.

Modern rehabilitation involves not only the restoration motor functions, but also withdrawal pain syndrome.

Stages, timing and methods of postoperative rehabilitation

When should postoperative rehabilitation begin? The answer is simple - the sooner the better. In fact, effective rehabilitation should begin immediately after the end of the operation and continue until an acceptable result is achieved.

The first stage of rehabilitation after surgery called immobilization. It lasts from the moment the operation is completed until the cast or stitches are removed. The duration of this period depends on what kind of surgical intervention the person underwent, but usually does not exceed 10–14 days. At this stage, rehabilitation measures include breathing exercises for the prevention of pneumonia, preparing the patient for physical therapy exercises and the exercises themselves. As a rule, they are very simple and at first represent only weak muscle contractions, but as the condition improves, the exercises become more complex.

From 3–4 days after surgery, physiotherapy is indicated - UHF therapy, electrical stimulation and other methods.

Second stage , post-immobilization, begins after removal of the cast or sutures and lasts up to 3 months. Now great attention Focused on increasing range of motion, strengthening muscles, and reducing pain. basis rehabilitation measures During this period, physical therapy and physiotherapy are performed.

Post-immobilization period divided into two stages: inpatient and outpatient . This is due to the fact that rehabilitation measures must be continued after discharge from the hospital.

Stationary stage involves intensive recovery measures, as the patient must leave the hospital as soon as possible. At this stage, the rehabilitation complex includes physical therapy, classes on special simulators,, if possible, exercises in the pool, as well as independent exercises in the ward. Important role Physiotherapy also plays a role, especially its varieties such as massage, electrophoresis, and ultrasound treatment (UVT).

Outpatient stage is also necessary, because without maintaining the achieved results they will quickly fade away. Typically this period lasts from 3 months to 3 years. IN outpatient setting patients continue physical therapy classes in sanatoriums and dispensaries, outpatient clinics physical therapy, medical and physical education clinics, as well as at home. Medical supervision patients' conditions are carried out twice a year.

Features of patient recovery after various types of medical procedures

Abdominal surgery

Like all bedridden patients, patients after abdominal surgery must perform breathing exercises for the prevention of pneumonia, especially in cases where the period of forced immobility is prolonged. Physical therapy after surgery is first carried out in a lying position, and only after the stitches begin to heal does the doctor allow you to perform exercises in a sitting and standing position.

Physiotherapy is also prescribed, in particular, UHF therapy, laser therapy, magnetic therapy, diadynamic therapy and electrophoresis.

After abdominal operations, patients are advised to follow a special gentle diet, especially if the operation was performed on the gastrointestinal tract. Patients should wear supportive underwear and bandages, this will help the muscles quickly restore tone.

Joint surgeries

The early postoperative period during surgical manipulation of the joints includes exercise therapy and exercises that reduce the risk of complications from the respiratory and cardiovascular system, as well as stimulation of peripheral blood flow in the limbs and improvement of mobility in the operated joint.

After this, strengthening the muscles of the limbs and restoring the normal pattern of movement (and in cases where this is impossible, developing a new one that takes into account changes in condition) comes to the fore. At this stage, in addition to physical education, mechanotherapy methods, exercises on simulators, massage, and reflexology are used.

After discharge from the hospital, it is necessary to maintain the results with regular exercises and conduct classes to adapt to normal everyday life. motor activity(occupational therapy).

Femoral neck endoprosthetics

Despite the seriousness of the operation, recovery from femoral neck replacement is usually relatively quick. In the early stages, the patient needs to perform exercises that will strengthen the muscles around the new joint and restore its mobility, and also prevent blood clots from forming. Rehabilitation after hip replacement also includes learning new motor skills - the doctor will show you how to sit, stand and bend over correctly, and how to perform normal everyday movements without the risk of injuring the hip. Great value have exercise therapy classes in the pool. Water allows you to move freely and eases the load on the operated hip. It is very important not to stop the rehabilitation course prematurely - in the case of hip surgeries this is especially dangerous. Often people, feeling that they can move around calmly without outside help, quit classes. But weak muscles quickly weaken, and this increases the risk of falling and injury, after which everything will have to start all over again.

Medical rehabilitation is not a new idea. Back in Ancient Egypt healers used some occupational therapy techniques to speed up the recovery of their patients. Doctors of ancient Greece and Rome also used physical education and massage in treatment. The founder of medicine, Hippocrates, wrote the following saying: “A doctor must be experienced in many things and, by the way, in massage.”

Heart surgery

Such operations are a real miracle modern medicine. But speedy recovery after such an intervention depends not only on the skill of the surgeon, but also on the patient himself and his responsible attitude towards his health. Yes, heart surgery does not limit mobility as much as surgical manipulation of the joints or spine, but this does not mean that restorative treatment can be neglected. Without it, patients often suffer from depression and their vision deteriorates due to swelling of the eye structures. Statistics show that every third patient who has not completed the rehabilitation course soon finds himself back on the operating table.

The rehabilitation program after heart surgery necessarily includes diet therapy. Patients are prescribed dosed cardio exercises under the supervision of a doctor and physical therapy, exercises in the pool (six months after surgery), balneotherapy and circular showers, massage and hardware physiotherapy. Important part rehabilitation program- psychotherapy, both group and individual.

Is it possible to carry out rehabilitation at home? Experts believe not. It's simply impossible to organize everything at home. necessary measures. Of course, the patient can perform the simplest exercises without the supervision of a doctor, but what about physiotherapeutic procedures, training on exercise machines, medicinal baths, massage, psychological support and others necessary measures? In addition, at home, both the patient and his family often forget about the need for systematic rehabilitation. Therefore, recovery should take place in a special institution - a sanatorium or rehabilitation center.

A hysterectomy is a surgical procedure in which the female reproductive organ. This operation is very common in gynecology. The uterus is removed in cases where all other treatment methods have been ineffective. Sometimes the uterus is removed along with fallopian tubes and ovaries. Postoperative period is important stage treatment of a woman, which may be accompanied by the development of complications, so it requires a professional approach.

Surgery to remove the uterus is quite common which is carried out for very serious illnesses, health threatening women. According to statistics, about a third of all women who have reached the age of 40 are forced to resort to such a procedure.

Trauma occurs with any surgical procedure. varying degrees severity that is associated with damage to tissues and blood vessels. After a hysterectomy, damage also remains, and it takes time for the tissue to fully recover. Duration postoperative rehabilitation depends on the severity of the disease, the type of surgery and postoperative complications.

More often removal of the uterus is indicated in the following cases X:

Depending on the severity of the disease carry out the following types operations:

removal of the uterus only;
removal of the uterus and cervix (total extirpation);
removal of the uterus with appendages and lymph nodes located nearby (radical panhysterectomy).

How severe the trauma will be depends not only on the type of operation, but also on the method of its implementation. The most radical is the abdominal technology, in which the walls of the peritoneum are cut, and another method is the vaginal method with an incision in the vagina. The least traumatic way is to remove the uterus laparoscopic method. In this case, a special laparoscope is used, which makes a very small incision. After laparoscopic surgery, complications are not so dangerous.

How long do you stay in hospital after a hysterectomy? It depends on the type of operation. After laparoscopy, the patient can be discharged the very next day. If abdominal surgery was performed, the patient can go home after 2 to 3 days.

Principles of rehabilitation

Recovery after surgery is divided into early and late stage. The early stage is carried out in a hospital setting under the supervision of a doctor. Its duration depends on the consequences that occurred after surgical intervention. The early stage of recovery after abdominal surgery usually lasts 9–12 days, after which the doctor removes the stitches and the patient is discharged. After laparoscopy, early rehabilitation is reduced to 3.5 – 4 days.

Main tasks early stage rehabilitation are:

relief from pain syndrome;
elimination of bleeding;
prevention of dysfunction of internal organs;
avoiding infection of the affected area.

The late stage of rehabilitation is carried out at home. If complications do not develop after the operation, then recovery takes 28–32 days, and in case of complications it is extended to 42–46 days. This stage is characterized full restoration tissues, strengthening the immune system, improving general condition, normalization psychological state, full restoration of functionality.

What measures are taken immediately after surgery?

On the first day after surgical intervention doctors are taking measures to eliminate painful symptoms, prevent complications from developing and inflammatory processes to prevent blood loss from internal bleeding and prevent the spread of infection. This period is very important early stage rehabilitation.

Key activities include specific activities.

Anesthesia. After the operation, the woman experiences natural pain in the inside and lower abdomen. To relieve pain, potent medications are prescribed.

Activation of organ functions. In this case, measures are taken to normalize blood circulation and stimulate the intestines. If such a need arises, then Proserpine is administered by injection to activate intestinal functions.

Diet. After surgery to remove the uterus and appendages, it is very important that normal intestinal motility is restored. The menu should consist of broths, drinks, pureed foods. If spontaneous defecation occurs at the end of the first day, it means that the event was carried out correctly.

Immediately after the operation the following drug therapy:

antibiotics to prevent infection;
anticoagulants to prevent the formation of blood clots in blood vessels;
infusion effect carried out using intravenous drips to restore blood volume and normalize blood circulation.

Complications during early rehabilitation

The first stage of rehabilitation may be accompanied by the following complications after hysterectomy:

How to recover after surgery? It is very important to prevent infection in the first 1–3 days. If this happens, the temperature rises to 38.5 degrees. To eliminate the risk of infection, the doctor prescribes antibiotics and carries out antiseptic treatment seam area.

Activities for late rehabilitation

After the woman is discharged from the hospital, her recovery from the hysterectomy continues. The late stage of rehabilitation allows the body to fully recover. Should the following actions are carried out:

It is very important to organize proper nutrition after removal of the uterus. A woman should not “push” and strain her abdominal muscles, so it is recommended to reduce the load on the intestines, trying not to eat aggressive and difficult-to-digest foods. The diet should be such that a laxative effect occurs.

Diet after hysterectomy includes the following approved products:

crumbly porridge;
green tea;
vegetable oil;
fresh vegetables and fruits (except grapes and pomegranates);
mashed boiled vegetables;
low-fat fermented milk products;
boiled meat.

Diet after hysterectomy surgery prohibits the following dishes and products:

A diet after surgery should only be prescribed by a doctor.

Consequences

After extirpation of the uterus along with the ovaries, the location of many pelvic organs begins to change. This rearrangement negatively affects the health of the intestines and bladder.

Consequences after removal of the uterus for the intestines and bladder:

constipation;
the appearance of hemorrhoids;
pain in the lower abdomen;
difficulty going to the toilet;
frequent urge to urinate without producing enough urine;
urinary incontinence;
problems with urine output that occur due to compression of the bladder.

After surgery the patient may experience the development of vascular atherosclerosis, and a woman can also gain overweight. Lymphostasis of the extremities often develops during surgery. To prevent this from happening, the lymph nodes are removed during the removal of the uterus, ovaries and appendages. Amputation of the uterus and ovaries ends in premature menopause. The body begins to rebuild itself because a lack of estrogen leads to irreversible changes. Hot flashes appear very often.

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The rehabilitation process takes from 3 months to 1 year after surgery, depending on its complexity. After 6 months, patients are recommended to continue exercising on rehabilitation equipment under the supervision of a physical therapy doctor or instructor in order to prevent hernia recurrence intervertebral disc, for which a set of exercises is individually selected to create a muscle corset and improve blood circulation in problem areas.

The recovery period takes place under the supervision of a neurologist, who prescribes a course drug therapy, recommends consultation with other specialists for more effective treatment.

Early rehabilitation period(from 1 to 3 months).

Do not sit for 3-6 weeks after surgery (depending on the severity of the surgery).
Do not make sudden and deep movements in the spine, bending forward, to the sides, twisting movements in lumbar region spine for 1-2 months after surgery.
Do not drive or ride in public transport in a sitting position for 2-3 months after surgery (you can ride as a passenger reclining, with the seat folded down).
Do not lift more than 3-5 kilograms for 3 months.
For 3 months after surgery, you should not ride a bike or exercise. game types sports (football, volleyball, basketball, tennis, etc.).
Periodically unload the spine (rest in a lying position for 20-30 minutes during the day).
Wearing a postoperative corset no more than 3 hours a day.
It is advisable not to smoke or drink alcohol during the entire rehabilitation period. Intimate life not contraindicated.

Rehabilitation:

As soon as the patient is allowed to walk, he should consult with a physical therapy doctor regarding the timing of the appointment and the complex of physical therapy, which depend on the volume and nature of the surgical intervention, as well as postoperative complications. A month after the uncomplicated operation, classes are indicated in the gym (not in the gym!) under the supervision of a physical therapy doctor, without deadlifts. Swimming on your stomach is beneficial.

A month after the operation, in uncomplicated cases, you can begin to work (the issue of timing and specific work performed is decided in each case individually with the attending physician).

Late rehabilitation period (3-6 months).

It is not recommended to lift more than 5-8 kilograms, especially without warming up and warming up the back muscles, jumping from heights, or long car trips.
When going outside in bad weather: wind, rain, low temperature, it is advisable to wear a warming belt on the lumbar area.
Wearing a corset, especially long-term, is not recommended to avoid atrophy long muscles backs.

Rehabilitation:

During this period, you can carefully, under the supervision of a physical therapy doctor, begin the formation of a muscle corset by doing exercises to strengthen the back muscles.

A healthy lifestyle, quitting smoking, regular exercise in the gym, swimming, sauna, and limiting weight lifting significantly reduce the risk of developing intervertebral disc herniations.

To prevent back pain, you should avoid: stress, hypothermia, prolonged monotonous work in a forced position, heavy lifting, sudden movements on cold, unheated muscles, overweight bodies.

In addition, at any stage of rehabilitation, acupuncture and physiotherapy can be included in the complex of rehabilitation measures.

Recommended set of exercises (one month after surgery)

Initially, do 1 to 5 repetitions of the exercises 2 times a day, building up to 10 repetitions of each exercise 2 times a day.
Perform the exercises smoothly and slowly, without sudden movements. If you feel discomfort while doing this or painful sensations, then don't do this exercise for a while. If such sensations become persistent, you should consult a doctor.
The intensity of the load depends on your well-being. As soon as pain appears, reduce the intensity of exercise.

Exercise 1. Lie on your back. Slowly bend your knees and press them to your chest, feeling the tension in your gluteal muscles. Relax your gluteal muscles. Keep your legs bent for 45-60 seconds, then slowly straighten them.

Exercise 2. Lie on your back, bend your knees, hands on the floor different sides. Raise your pelvis above the floor and hold for 10-15 seconds. Increase the holding time to 60 seconds.

Exercise 3. Lie on your back, hands behind your head, legs bent at the knees. Turn your legs alternately, first to the right, then to left side touching the floor with your knee; the upper body remains in horizontal position. Hold your legs in the rotated position for up to 60 seconds.

Exercise 4. Lie on your back, bend your knees, cross your arms over your chest, press your chin to your chest. Tightening your abdominal muscles, bend forward and hold this position for 10 seconds, then relax. Repeat 10 to 15 times, gradually increasing the number of repetitions.

Exercise 5. Starting position on your hands and legs bent at the knees. Simultaneously left leg And right hand pull horizontally and lock in this position for 10 to 60 seconds. Repeat, raising your right arm and left leg.

Exercise 6. Starting position: lying on your stomach, arms bent in elbow joints, lie near the head. Straighten your arms and raise top part body and head up, bending in lumbar region, while keeping your hips off the floor. Hold this position for 10 seconds. Get down on the floor and relax.

Exercise 7. Starting position: lying on your stomach, hands under the chin. Slowly, low, lift your straight leg up without lifting your pelvis from the floor. Slowly lower your leg and repeat with the other leg.

Exercise 8. Starting position: stand on one leg, the other straightened, place it on a chair. Leaning forward, bend the leg lying on the chair at the knee and hold in this position for 30-45 seconds. Straighten up and return to the starting position.