Post Operative Course

Pain Control

Pain Control Prescriptions will be provided by the doctor

Narcotics

  • Vicoden, Darvocet N100, Percocet, Oxycodone etc.
    • 1-2 pills every 4-6 hours as needed for pain
    • most patients use this for 2-7 days

Non-Steroidal anti-inflammatory agents (NSAIDs)

  • Ibuprophen = Advil
    • 600-800 mg every 6 hours as needed for pain
  • up to 50% will use just this for pain control
  • You may take NSAIDs in combination with the Narcotics and the need for narcotic is reduced by 50%

Wound Care

Incisions are to be kept moist at all times by a saline compress or a sealed Tegaderm

Saline Compress

Change 2-3 time per day to keep incision moist

  1. Apply Double antibiotic ointment to the incision
  2. Cover with a saline wet gauze and a dry gauze
  3. Hold in place with surgical gauze
  4. Place saran over the dressing under the bra to keep clothes dry e. Make your own saline: 4 cups of water + 1 tablespoon salt

Tegaderm

  1. If the edges are sealed, do not remove it. Replace only if seal is broken and wound/ gauze are exposed to the air
  2. If the wound is not oozing, replace dressing with a new Tegaderm/ transparent dressing and no ointment or gauze
  3. If the wound is not oozing, replace the Tegaderm/transparent dressing with double antibiotic ointment and a slightly damp piece of gauze and dry gauze covered by the Tegaderm . If it is sealed all the way around the gauze, the dressing does not need to be replaced for 7-10 days.

Scar Management

Your scars will be firm and pink for at least six weeks. Then they may remain the same size or even appear to widen over the next 6 weeks. Between 3 & 12 months the scars slowly become thinner, flatter and fade.

  • Deep Massage starting at 3-4 weeks
  • silicone topically in sheets or paint when oozing stops
    • speeds maturation of scar
    • reduces redness
    • flattens and softens scar
  • Mederma
    • Does not hurt
    • No proven benefit
  • DO NOT apply Vit E: this may widen the scar

Normal Scars

  • increase in thickness and redness in 1st 6 weeks
  • stagnate for 2nd 6 weeks
  • start to break down between 3 months and 1 year

Hypertrophic Scars

  • thickening of the scar, irritation
  • Deep Massage, Silicone, Topical Steroids

Keloids

  • Thickened scar that extends beyond the incision
  • Deep Massage, Silicone, Topical Steroids, Injectable Steroids, 5 F/U, Excision Radiation Therapy