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

When can I wet the suture after surgery? This question interests many patients. I must say that the types of operations are very different, and the types of dressings too. If the 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 got on it, then it's not scary. After washing, it is enough to 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 wet it. There are several types of dressings, some of them do not get wet, but if you are not sure about this, then you should be careful. Bandages should not be removed without the doctor's permission.

Hygiene is essential to ensure proper wound healing.

In order to avoid soaking the seam, do the following:

You need to cover the seam before washing. To do this, use bandages that are waterproof. To protect the seam, you can use a rubber bandage or a plastic bag.
In the first days after the operation, it is strictly forbidden to take a bath. You can only swim in the shower.
It is not necessary to rub the seams with a washcloth.
Even if the seam is not wet, then you need to blot it with a clean towel. This will prevent water from entering the wound.
In the event that the seams get wet, then blot them, and then process them.

Postoperative suture care is the same in most cases. For normal process healing, you need to regularly treat them with special skin antiseptics. It can be iodine, brilliant green, potassium permanganate of medium strength, hydrogen peroxide or furacilin.
It is very important to adhere to the rules of hygiene and cleanliness.

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

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

There are several types of materials that are superimposed on the seams. In addition, there may be several ways to 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 stitches 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 in about a week. Often, if necessary, the suture is drained, and the doctor should also instruct how to care for it in this case. You can independently remove the material that is used as drainage.

It is very important to control your condition. If deterioration has begun or the body temperature has risen, pain in the wound, swelling, hyperemia of the sutures, bumps and swelling have appeared, then you should immediately consult a doctor. Very often, in order to speed up wound healing, ointments containing antibiotics, such as levasin or levomekol, are prescribed.

If an inflammatory process is observed in the wound, then a compress with dimexide can be applied. In addition, it is worth undergoing antibiotic therapy.

Depending on the type of operation, the wounds begin to heal in an average of 7-14 days. Scars lighten in about 4-5 months. Sometimes the use of ointments for accelerated healing scarring is meaningless. If the operation was serious, then you can take a shower only after 6 days.

Baths should not be taken until the wound heals. Since 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 bathe in the bath. Influence warm water on the wound is undesirable, since this may be the cause of undesirable processes in the scar.

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

But you can use it after the wound heals. They need to be used for a very long time. If the operation took place on abdominal cavity then you should wear special supportive underwear. This will avoid the development of a hernia.
Hygiene is very important.

In addition to nutrition, a lot of questions are related to behavior in Everyday life after gallbladder surgery, the answers to which I have collected for you, dear readers, in the comments to the articles. Perhaps they will help many of you overcome difficult period adaptation and live a normal and full life. How to live after gallbladder removal?

When can I 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 water bodies in a month, but it is necessary to avoid stress on the press. You can actively swim no earlier than 6 months after the operation. The water temperature should be comfortable so as not to cause spastic contraction of the intestines.

For the first 6 months, it is not recommended to sunbathe on purpose, in addition, you need to use a closed swimsuit in the sun (persistent pigmentation may appear in the place postoperative sutures under the influence of the sun). You can sunbathe only 6 months after the operation.

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

It is possible to engage in active swimming in the pool six months after the operation. You can simply splash in the pool without a heavy load on the abdominal muscles already a month after the operation.

Can I ride a bike and rollerblade after gallbladder surgery?

In a quiet tourist mode, you can start cycling a month after the operation. But actively rollerblading and cycling in sports mode is possible only 6 months after the operation, the risk of postoperative ventral hernias is so high

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

It is possible and necessary to engage in physical education after removal of the gallbladder. In the first 6 months after surgery, it is advisable to avoid intensive loads on the press. With regard to stress, 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, in the second month - four kilograms. In both cases, intense stress on the press should be avoided in the first six months.

6 months after surgery 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 sport dancing?

It will be possible to go in for ballroom dancing already a month after the operation, sports dancing - in six months.

4 months have passed since the removal of the gallbladder, is it possible to practice yoga?

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

Can I have sex after the operation?

Within reasonable limits, sexual life can begin to live within a week after the operation. The first 1.5 months it is desirable to avoid intense sexual intercourse.

In what time period after the operation is it possible to undergo sanatorium-resort treatment and is it possible to fly by plane?

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

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

Special weight loss techniques can be practiced one year after the operation. That will be safe. In addition, it should be noted that strict adherence to diet No. 5, which is recommended for those who have had their gallbladder, leads, as a rule, to weight loss, and if you follow it, then the problem with weight will gradually go away.

It has been 3 months since the operation. Can I do anti-cellulite massage and vacuum in the abdomen?

We'll 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 visit the sauna?

Yes, it is already possible, just be careful, do not stay too long, focus on your own well-being.

These are the recommendations from Evgeny Snegir and me for everyone who has undergone gallbladder surgery. And remember, the most important thing is your positive thoughts mind that everything will be fine. And, of course, you should stick to a diet, at least in the first year and a half years after the operation. And food like this can be just delicious and varied. Health to all and the joys of life.

Any surgery- a serious intervention in the body, and one should not expect that after it everything will be “as before”. Even if the surgeon who performed the operation is a real genius of medicine 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? Everything will heal, and the body will recover itself, ”so, alas, many people in our country think. But it should be borne in mind that in a weakened organism, the possibilities for self-healing are reduced. Some operations, in particular on the joints and spine, require mandatory restorative measures, otherwise there is a risk that a person will never return to habitual way life. In addition, without rehabilitation after surgery, there is a high risk of complications caused by prolonged immobility. And not only physical ones - such as muscle atrophy and bedsores, as well as pneumonia caused by congestion- but also psychological. A man who until recently could move and serve himself, is chained to a hospital bed. This is a very difficult situation, and the task of rehabilitation is to return the person and good health and spiritual comfort.

Modern rehabilitation provides not only recovery motor functions, but also the removal pain syndrome.

Stages, terms 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 continues from the moment the operation is completed until the plaster or sutures are removed. The duration of this period depends on what kind of surgery 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 physiotherapy exercises and the exercises themselves. As a rule, they are very simple and at first they represent only weak muscle contractions, but as the condition improves, the exercises become more difficult.

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

Second phase , post-immobilization, begins after the removal of plaster or sutures and lasts up to 3 months. Now great attention is given to increase the range of motion, strengthen muscles, reduce pain. basis rehabilitation activities during this period are physiotherapy exercises and physiotherapy.

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 physiotherapy exercises, classes on special simulators, if possible - exercises in the pool, as well as self-study in the ward. Important role physiotherapy also plays, especially its varieties such as massage, electrophoresis, ultrasound treatment (SWT).

Outpatient stage is also necessary, because without maintaining the results achieved, they will quickly come to naught. Usually this period lasts from 3 months to 3 years. IN outpatient settings patients continue physical therapy classes in sanatoriums and dispensaries, outpatient clinics physiotherapy exercises, medical and physical education dispensaries, as well as at home. Medical control condition of patients is carried out twice a year.

Features of the recovery of patients after medical manipulations of various types

Abdominal operation

Like all bedridden patients, patients after abdominal operations should perform breathing exercises for the prevention of pneumonia, especially in cases where the period of forced immobility is prolonged. Physiotherapy exercises after surgery are first performed in the supine position, and only after the stitches begin to heal, the doctor allows you to perform exercises in a sitting and standing position.

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

After abdominal operations, patients are shown a special sparing 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 operations

The early postoperative period during surgical manipulations on the joints includes exercise therapy and exercises that reduce the risk of complications from the respiratory system and of cardio-vascular system, as well as stimulation of peripheral blood flow in the extremities and improvement of mobility in the operated joint.

After that, strengthening the muscles of the limbs and restoring the normal movement pattern (and in cases where this is not possible, developing a new one that takes into account changes in the state) comes to the fore. At this stage, in addition to physical education, methods of mechanotherapy, exercises on simulators, massage, reflexology are used.

After discharge from the hospital, it is necessary to maintain the result with regular exercises and conduct classes to adapt to normal daily motor activity(ergotherapy).

Endoprosthetics of the femoral neck

Despite the seriousness of the operation, rehabilitation for femoral neck prosthetics usually passes relatively quickly. In the early stages, the patient needs to perform exercises that will strengthen the muscles around the new joint and restore its mobility, as well as prevent blood clots from forming. Rehabilitation after hip arthroplasty also includes learning new motor skills - the doctor will show you how to sit, stand up and bend over correctly, how to perform normal daily movements without the risk of injuring the hip. Great importance have exercise therapy classes in a swimming pool. Water allows free movement and relieves the load on the operated hip. It is very important not to stop the rehabilitation course ahead of schedule - in the case of hip surgery, this is especially dangerous. Often people, feeling that they can safely move around without outside help drop out of classes. But weak muscles quickly weaken, and this increases the risk of falling and injury, after which everything will have to start over.

Medical rehabilitation is not a new idea. Also 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 the treatment. The founder of medicine Hippocrates owns the following saying: "The doctor must be experienced in many things and, among other things, in massage."

Operations on the heart

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 to his health. Yes, heart surgery does not restrict mobility in the same way that joint or spinal surgery does, but that does not mean that rehabilitation treatment can be neglected. Without it, patients often suffer from depression, and their vision deteriorates due to swelling of the structures of the eye. Statistics show that every third patient who has not completed a course of rehabilitation soon finds himself on the operating table again.

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

Is it possible to carry out rehabilitation at home? Experts believe not. At home it is simply impossible to organize everything necessary measures. Of course, the patient can perform the simplest exercises without the supervision of a doctor, but what about physiotherapy procedures, exercises on simulators, therapeutic 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 when all other treatments have failed. Sometimes the uterus is removed along with fallopian tubes and ovaries. Postoperative period is milestone 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 with very serious ailments, 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.

In any surgical intervention, injuries occur varying degrees severity associated with damage to tissues and blood vessels. After a hysterectomy, damage also remains, and it takes time for the tissues to fully recover. Duration postoperative rehabilitation depends on the severity of the disease, the type of operation 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 only the uterus;
removal of the uterus and cervix (total extirpation);
removal of the uterus with appendages and lymph nodes located nearby (radical panhysterectomy).

How strong the traumatization 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 the removal of 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 people stay in the hospital after a hysterectomy? It depends on the type of operation. After laparoscopy, the patient can be discharged The next day. If an abdominal operation 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 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 is usually 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:

getting rid of pain syndrome;
elimination of bleeding;
prevention of violations of the functions of internal organs;
exclusion of infection of the affected area.

The late stage of rehabilitation is carried out at home. If no complications 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 recovery tissues, strengthening immunity, improving general condition, normalization psychological state, full restoration of working capacity.

What measures are carried out immediately after the operation?

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

The main activities include certain actions.

Anesthesia. After the operation, the woman has natural pains inside and in the lower abdomen. To anesthetize, prescribe potent drugs.

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

Diet. After surgery to remove the uterus with appendages, it is very important that normal intestinal motility is restored. The menu should consist of broths, drinks, mashed foods. If at the end of the first day there was an independent defecation, then the event was carried out correctly.

Immediately after the operation, the following drug therapy:

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

Complications in 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 in the first 1 - 3 days to prevent infection. If this happens, then the temperature rises to 38.5 degrees. To eliminate the risk of infection, the doctor prescribes antibiotics and antiseptic treatment seam area.

Activities for late rehabilitation

After the woman is discharged from the hospital, her recovery after the removal of the uterus continues. The late stage of rehabilitation allows the body to fully recover. Must 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 indigestible foods. Nutrition should be such that a laxative effect occurs.

Diet after hysterectomy includes the following permitted products:

crumbly cereals;
green tea;
vegetable oil;
fresh vegetables and fruits (except grapes and pomegranate);
mashed boiled vegetables;
low-fat dairy products;
boiled meat.

Diet after hysterectomy prohibits the following dishes and products:

The diet after surgery should be prescribed only 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, not leading to sufficient urine output;
urinary incontinence;
urination problems that occur due to squeezing of the bladder.

After operation the patient may experience development of vascular atherosclerosis, and a woman can gain excess weight. Against the background of the operation, lymphostasis of the extremities often develops. To prevent this from happening, during the removal of the uterus with the ovaries and appendages, the lymph nodes are removed. Amputation of the uterus and ovaries ends with premature menopause. The body begins to rebuild, because the lack of estrogen leads to irreversible changes. Hot flashes are very common.

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The rehabilitation process takes from 3 months to 1 year after the operation, depending on its complexity. After 6 months, patients are advised 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 muscular 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 consultations of other specialists for more effective treatment.

Early rehabilitation period(from 1 to 3 months).

Do not sit for 3-6 weeks after the operation (depending on the severity of the operation).
Do not make sharp and deep movements in the spine, tilt forward, to the side, twisting movements in lumbar spine within 1-2 months after surgery.
Do not drive and do not ride in transport in a sitting position for 2-3 months after the operation (you can drive as a reclining passenger with the seat unfolded).
Do not lift more than 3-5 kilograms for 3 months.
For 3 months after the operation, do not ride a bicycle, exercise game types sports (football, volleyball, basketball, tennis, etc.).
Periodically unload the spine (rest in the supine position for 20-30 minutes during the day).
Wearing a postoperative corset for 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 an exercise therapy doctor regarding the timing of the appointment and the complex of physiotherapy exercises, which depend on the volume and nature of the surgical intervention, as well as postoperative complications. A month after an uncomplicated operation, classes are shown in the gym (not in the gym!) Under the supervision of an exercise therapy doctor, without deadlifts. Beneficial swimming.

A month after the operation, in uncomplicated cases, you can start working (the question of the 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 a height, long car trips.
When going outside in bad weather: wind, rain, low temperature, it is advisable to wear a warming belt on the lumbar region.
Wearing a corset, especially for a long time, is not recommended in order to avoid atrophy long muscles back.

Rehabilitation:

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

A healthy lifestyle, smoking cessation, regular exercise in the gym, swimming, bathing, limiting weight lifting significantly reduce the risk of developing herniated discs.

To prevent back pain, you should avoid: stress, hypothermia, prolonged monotonous labor in a forced position, weight lifting, sudden movements on cold, not warmed up muscles, the appearance overweight body.

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)

At first, do 1 to 5 repetitions of exercises 2 times a day, increasing to 10 repetitions of each exercise 2 times a day.
Perform exercises smoothly and slowly, without sudden movements. If you experience any discomfort or pain, then do not do this exercise for a while. If such sensations become persistent, you should consult a doctor.
The intensity of the load depends on how you feel. As soon as pain appears, reduce the intensity of exercise.

Exercise 1. Lie on your back. Slowly bend your knees and press to your chest, feel the tension in the gluteal muscles. Relax the 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 in different sides. Raise your pelvis off the floor and hold for 10-15 seconds. Adjust 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 the knee; upper body remains horizontal position. Hold your legs in a 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 the abdominal muscles, bend forward and hold in this position for 10 seconds, then relax. Repeat 10 to 15 times, gradually increasing the number of repetitions.

Exercise 5. Starting position on the 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 by 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, raise upper 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 the stomach, hands under the chin. Slowly, low, lift your straight leg up without lifting your pelvis off the floor. Slowly lower your leg and repeat with the other leg.

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