General Postoperative
Instructions
Christian Lattermann, MD
University of Kentucky Sports Medicine
Director: Center for Cartilage Repair and Restoration
Kentucky Clinic K401
740 South Limestone
Lexington KY 40536
(859) 218 3065
Email:
1.Keep the wound clean and dry. The dressing should be removed on the second day after surgery. Do not remove the paper strips (steri-strips) or cut any of the visible suture. Reapply the ace wrap, if applicable, for 5-7 days to control swelling. Wounds should be kept dry for 48 hours. Unless otherwise instructed, on post -op day 2, the wound may be exposed in the shower without scrubbing the area. The wound should not be submerged in a bathtub or pool until three weeks after surgery.
2.Icing is very important for the first 5-7 days postoperative. While the post-op dressing is in place, icing should be done according to the nurses instructions. As long as the initial dressing is in place, icing can generally be done for 20 minutes on-20 minutes off. Once the dressing is removed on the first or second day, ice is applied for 20-minute periods 3-4 times per day. Care must be taken with icing to avoid frostbite to the skin. The icing device (cryocuff, game ready or ice bags) should at no time ever be in direct contact with the skin!
3.Follow weight bearing instructions as advised at discharge. Crutches or a cane may be necessary to assist walking. Extremity elevation for the first 72 hours is also encouraged to minimize swelling. The leg should be propped up behind the heel and NOT behind the knee!
4.The anesthetic drugs used during your surgery may cause nausea for the first 24 hours. If nausea is encountered, take the prescribed Phenergan as directed and drink only clear liquids (i.e. Sprite or 7-up). The only solids should be dry crackers or toast. If nausea and vomiting become severe or the patient shows sign of dehydration (lack of urination) please call the doctor or the Surgicenter. A low-grade fever (100.5) is not uncommon in the first 24 hours but unusual beyond. Please call the doctor with any temperature over 101.0 degrees. If a spinal anesthetic was used, patients may suffer a spinal headache. Please call the SurgiCenter should this occur and itdoes not resolve.
5. You may take a baby aspirin (81 mg) daily until the sutures are removed in the office. This may lower the risk of a blood clot developing after surgery. Should severe calf pain occur or significant swelling of calf and ankle, please call the doctor. Please do not take the aspirin if you have a known allergy to aspirin or a history of stomach bleeds / ulcers.
6. Local anesthetics (i.e. Ropivacaine) or a regional nerve block will be used to control your post-operative pain. It is not uncommon for patients to encounter more pain on the first or second day after surgery. This is the time when swelling peaks. Taking pain medication before bedtime will assist in sleeping. It is important not to drink or drive while taking narcotic medication. If you were prescribed narcotic medication (i.e. vicodin, hydrocodone, oxycodone) you can supplement those medications with 200 mg or 400 mg of ibuprofen every 4-6 hours after consultation with your physician. You should resume your normal medications for other conditions the day after surgery. For some surgeries your doctor may elect to give you a limited script for 4 tablets of pure Oxycodone. Oxycodone is a very powerful narcotic that is only to be taken for severe uncontrollable pain. For most procedures pain medication will be required for less than 2 weeks. Occasionally patients have to take them longer. Our policy is to wean every postoperative patient from narcotic pain medication after 6 weeks at the latest. Please never take narcotic pain medication unlessyou have at least 4-5/10 pain. For lesser pain, Tylenol extra strengths (no more than 6/day) or anti-inflammtory drugs such as aleve or advil will be adequate.
7.Dr. Lattermannwill need to re-examine you in 7-10 days after surgery.The appointment will already have been made through the scheduler and you have been given an appointment card. If you have lost this card or are not sure about the appointment or have to reschedule ,please call Jackie Musick, Dr. Lattermann's surgery coordinator, at 859 218 3140.
8.Most patients are able to drive if surgery does not involve their right leg as soon as they stop taking narcotic pain medication. Driving while under the influence of narcotic pain medication is dangerous, illegal and greatly discouraged in all patients. Returning to school or work also depends on the degree of postoperative pain and the demands of your job. Pain is generally a good guide as to whether you can return or not. After shoulder surgery driving is generally not possible until the sling is being taken off which is normally around the 4 week time point.
9. If unexpected problems, emergencies or other issues occur and you need to talk to the doctor, call our administrative assistant Joyce at (859) 218 3065. Joyce will take care of your concerns and route you to either Rebecca Mercer PA-C, the sports medicine fellow on Dr. Lattermann's service or Dr. Lattermann to answer your questions. After hours our answering service will route your call to a physician who will be able to advice you concerning your problem. For less urgent or general questions, Dr. Lattermann can also be reached via email .