OrthoNeuroSpine & Pain Institute
Post Operative Instructions
Before you are discharged from the hospital, Dr Eugene Wong and his team will give you specific postoperative instructions for you to follow at home depending on the type of surgery you undergo. This will include any activity restrictions, instructions on the care of surgical incisions, and medication usage. Following these instructions is crucial to your recovery. If you are unsure of any of these instructions, ask for clarification.
In general, you can expect your surgical wound to be sore immediately following surgery, and this should improve day-to-day over the 2-4 postoperative weeks. Your leg or arm pain may be immediately improved or even gone, or you may continue to experience some pain for a number of days to weeks. Even if your extremity pain is completely gone after surgery, you can expect some intermittent pain over the first six weeks after surgery, as the surrounding tissues heal and inflammation subsides. Do not worry if this happens; it is a normal occurrence. Severe persistent leg or arm pain should not recur, and should be reported to Dr Wong
Spinal surgery often involves more than one incision depending on the surgical approach used to perform the operation. When you are discharged home you may still have a surgical dressing on your incision. The tape strips on the skin should be left in place. They may get wet in the shower, but should not be rubbed with a washcloth or a drying towel or they may come off. Carefully dry this area by patting rather than rubbing. Eventually, the tape strips will fall off on their own; if they are still in place they will be removed at the time of the first postoperative office visit. Do not bathe or soak the wound site until after the first postoperative visit.
At the time of hospital discharge, your wound is being covered by an outer gauze dressing held on by clear plastic or white tape, and an inner dressing of white tape strips applied directly to the skin. You should not shower with the outer dressings on, but instead should sponge bathe around the collar. During this early recovery period, you will also be instructed to keep your incision clean and dry, making sure only to use soap and water to cleanse the area. If there is any drainage from the wound when home, you should keep it dry, wash around it, and keep it covered with a sterile gauze dressing changed at least daily. This is especially true if there is any persistent drainage from the wound itself.
The wound stitches (sutures) are absorbable. The ends of the suture may be protruding from the skin at the ends of the wound. These should be left alone, or covered with a gauze if they are irritating under the brace. These ends will be removed at the first postoperative visit if they have not fallen off on their own.
Call Dr Wong's office to report any persistent drainage for over two days, to discuss and receive specific instructions for your particular situation. Antibiotics may be prescribed for 7-10 days and should be used until finished.
Showering and getting the wound wet is generally permitted once the wound is dry and without drainage, but the wounds should not be submerged in a tub, pool, or body of water until it has healed. You should also avoid the use of skin lotions in the area of the incision(s) in the early postoperative period; you need to keep this area dry until it has had the opportunity to heal well.
If you have a brace then it can be removed for the shower and reapplied afterwards. In some circumstances we will be given strict instructions to keep the brace on at all time including showering. You may be given a second brace to be used for showering which can get wet, unless instructed otherwise by Dr Wong. If you only have one brace, do not get it wet; wash around it. You may contact Dr. Wong’s office to fax or mail a prescription for a second brace.
In addition to caring for your incision(s), you will also be encouraged to:
- Drink plenty of fluids
- Avoid the use of nicotine (cigarettes/cigars, chewing tobacco)
- Maintain a healthy diet (high in protein)
- Perform deep-breathing exercises regularly
- Gradually increase your physical activity
- Activities to avoid usually include any heavy lifting, bending, or twisting, although specific activity instructions in your case should be discussed with Dr Wong and members of his team prior to hospital discharge
If any signs of possible infection are observed, you should call Dr Wong's office to check in with him or a clinical staff member. These signs include
Fever - a body temperature greater than 38°C
Persistent or worsening drainage from the incision(s)
Opening of the incision(s), and
Redness, warmth, or increased tenderness around the incision(s)
In addition, call Dr Wong to report any chills, nausea/vomiting, or if you suffer any type of trauma (e.g., a fall, automobile accident) which may have impacted the surgical area
Discharge medications will usually consist of a narcotic pain reliever and a muscle relaxant.
In general, patients should be up and walking as much as possible after surgery. This will help to condition the traumatized muscles and decrease the incidence of complications like deep venous thrombosis, pulmonary embolism, and pneumonia. I encourage patients to walk up to 2 miles a day by the time they are six weeks postoperative. Avoid heavy lifting, bending, or twisting activities over the first 6 weeks after surgery. Lifting should be avoided - nothing heavier than a filled coffee cup, for six weeks as well. Specific activity instructions in your case should be discussed with Dr Wong and members of his team prior to hospital discharge.
Outpatient postoperative physical therapy may be prescribed at the first postoperative office visit if needed. However most patients can exercise at home on their own and do not need formal physical therapy.
In general, most patients will be cleared for driving after the two-week postoperative visit. Return to desk-type work can be allowed 2-6 weeks after surgery, depending on postoperative symptoms and expected commute. Return to physical labor is usually at 12 weeks after the operation. Resumption of previous recreational physical activities is generally begun at 12 weeks postoperatively.
During the first few days home, contact Dr Wong’s office to schedule your first postoperative office visit, generally at 2-4 weeks from the time of surgery. If a fusion surgery was done X-rays are performed just prior to seeing Dr Wong Please be sure to call Dr Wong 's office at any time if you have any urgent questions or concerns. There is always someone from his team covering his patient service at all times, if he is not directly available to respond.