Thank you for choosing Augusta University Medical Center and the Minimally Invasive and Digestive Diseases Surgery Section at the Medicla College of Georgia for your healthcare needs. This information is to help answer come common questions you may have about your operation and provide instructions to follow during your recovery period.
Surgery of the skin and soft tissues of the body may need to be done for many different
reasons, sometimes for benign diseases and sometimes for cancer. The operations themselves
are very similar, but the work-up and follow up may be quite different. Most skin
and soft tissue surgery is done as an elective procedure and usually on an outpatient
or ambulatory basis. Sometimes, emergency surgery such as incision and drainage of
a skin or soft tissue infection (abscess) or debridement (excision) of dead (devitalized
or necrotic) tissue is needed. Depending on the extensiveness of infection or devitalized
tissue, admission for further wound care and need for IV antibiotics may be required.
For more detailed information on skin and soft tissue disorders and types of surgery
done for these conditions, click here.
Preoperative Information
Prior to surgery, you will be asked not to eat or drink anything after midnight prior
to your surgery. You will be given specific instructions from your surgeon or anesthesiologist
about which medications you should or should not take prior to your surgery. You should
not take any blood thinning medications at least 5 days prior to your operation. This
should be discussed with your surgeon at your preop visit.
Postoperative Information
Your recovery will vary depending on the location of the surgery and the extensiveness
of the surgery. You should begin walking the night of surgery and continue to increase
as you are able to decrease the risk of blood clots and improve breathing to prevent
pneumonia.
Activity
You can resume most usual activities gradually beginning shortly after surgery. If
you had a large incision in an area that is under high stress from movement, like
the shoulder, back or leg, you may have some restrictions placed on your activity.
Ask your surgeon about any restrictions you will have after surgery.
Avoid driving until you no longer need narcotic pain medication and you feel you can make rapid movements unimpaired by pain. Driving while taking narcotics can impair your ability to drive safely.
You should be able to return to work within a few days after surgery. This may change if there was significant infection or extensive surgery needed.
Wound Care
A small gauze and clear tape dressing or a small white dressing is typically placed
over each incision. These dressings can be removed 48 hours (2 days) after the operation.
Below this dressing are small brown or white pieces of tape (called Steri-Strips);
these will fall off on their own within 1-2 weeks or be removed at your follow-up
visit with your surgeon. If your surgeon gives you specific instructions other than
this, please follow those instructions.
You may shower after 48hours (after the gauze and clear tape dressing is removed). It is okay to get soap and water on the incisions. Pat the area dry. It is not recommend that you submerge underwater (in a bathtub, pool, or hot-tub) for at least two weeks post-op.
Following removal of large soft tissue lesions, fluid can sometimes build up in the space where the soft tissue lesion was. This may look like the soft tissue lesion has come back or cause some discomfort, but there is usually no treatment needed and the fluid will go away on its own. Sometimes, these fluid collections can become infected, so watch for redness over the area, drainage or fever. If this occurs, call your doctor.
Following skin and soft tissue surgery, bruising around the incision is common. This will resolve on its own in 2-3 weeks.
If you had a large incision in an area that is under high stress from movement, like the shoulder, back or leg, you may have stitches placed in the skin to decrease the chances for the skin opening. If so, you may put antibiotic ointment over the stitches if you want to, though it is not necessary. You may need to place a gauze over the area to keep the stitches from catching on your clothes.
If you notice drainage from your incisions, particularly if it is thick and foul-smelling or associated with a fever, contact your surgeon.
If you notice redness around your incisions, especially if it is getting worse or associated with drainage or a fever, contact your surgeon.
If your incision was left open due to infection risk, or if you developed an infection in one of your incisions, you may need to change a gauze dressing twice a day until the wound heals. A wound vac (vacuum-assisted wound care device) may be needed for very large open wounds to speed up healing.
Medications - Pain Management
You will be discharged with pain medication, typically a mild to moderate strength
narcotic. Take as needed and as prescribed. You may also take over-the-counter medications
such as ibuprofen for pain. Most narcotic medications prescribed are combined with
Tylenol (acetaminophen) and you should not take additional Tylenol if you are taking
a narcotic medication that already contains Tylenol.
Pain after a removal of a large soft tissue lesion, debridement of devitalized tissue, or incision and drainage of a soft tissue abscess can be significant. You will probably be admitted to the hospital at least overnight. You will most likely be placed on IV narcotics using a pump (PCA � patient controlled analgesia), which allows you to press a button for additional medication when you need it. This will be weaned off within a few days of your operation and you will start oral pain medications. It is very important to us that your pain be well controlled. Your pain should be controlled well enough for you to begin getting out of bed the morning after surgery and for you to perform deep breathing exercises. If you have pain that is not well enough controlled to allow you to walk or breathe deeply, talk to your surgery team. You may need to have your pain medications changed or increased.
Other Medications
If your surgery was needed due to infection, you may be prescribed antibiotics when
you go home. Not every surgery for infection needs to take antibiotics at home, so
ask your doctor if you need them. If you are sent home with antibiotics, take the
full course as prescribed.
Home Medications
Unless otherwise instructed, you should be able to resume your usual home medications
the night of or the morning following your surgery.
Click here for more detailed information on commonly prescribed medications.
Diet & Bowel Care
You may resume your usual diet as you feel able unless otherwise instructed. Your
appetite may be less than usual but typically returns to normal within a week or two.
Be sure to drink plenty of liquids (6-8 glasses of water or juice each day) if your
appetite is not very good.
You may be prescribed a stool softener when you go home. Pain medications can cause constipation and a stool softener may help. You may also be given nausea medication if you have experience nausea or vomiting from taking your pain medication.
It is common to have some constipation after surgery, especially when taking narcotic
pain medications. You will probably be prescribed a stool softener when you are discharged.
If you are having trouble moving your bowels after surgery (if your stool is hard
or you have to strain excessively) you may need a laxative. Over the counter medications
can treat this well. Senna, Miralax, or dulcolax are some of the most common and are
available at most drug stores or grocery stores. Take as directed.
If you are having trouble having a bowel movement AND have abdominal bloating, nausea
or vomiting, and not passing gas, call your doctor.
Follow Up
You will be given a date and time to see your surgeon following surgery, usually in
7 to 10 days. If you are discharged late in the day or over the weekend, you will
be given a number to call the following business day for an appointment. If you are
having trouble making an appointment, call your doctors' office directly for assistance.
Call Your Doctor If:
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Contact Information
Daytime hours: Call 706-721-4686 or 7597
After hours and weekends: Call 706-721-8400