Wounds after surgery
With minimally invasive surgery, you will have a small scar that goes between the ribs. The skin incisions are closed with internal sutures. You may also have small incisions in the chest, groin, arm or leg, or small wounds where drains, provisional pacemaker wires or catheters were placed.
Wound care postoperatively
14 days after surgery, stitches may be removed by the family doctor or home care nurse. The wounds may remain open until then. If they are nice and dry, they do not need to be covered by a plaster. Fluid loss is normal for the first 3 to 5 days after surgery.
Showering is possible a few days after surgery if your condition allows it. When showering, avoid a direct spray on the wound. It is important that you dry the wounds thoroughly. A bath should be avoided until all stitches are removed and the wounds have healed properly.
Hygienic care of the wound at home
You may wash your scar daily. How to proceed?
- Wash your hands before touching the incision.
- Look in the mirror. Inspect your scar for
- Fluid loss
- There should be no gap between the edges of the wound
- Gently wash your scar with ordinary soap (not scented) using a washcloth with warm water and gentle pressure.
- Pat the wound dry with a clean towel.
- You should not cover the scar unless with fluid loss.
- In case of fluid loss, wash your hands after caring for the scar.
Weight after heart surgery
After cardiac surgery, some patients may accumulate (withhold/hold) fluid. The majority of patients leave the hospital at or below their preoperative weight. Some patients lose the extra weight more slowly or have problems with the extra fluid when they go home.
To restore fluid balance, the following points should be observed:
- avoid adding salt when preparing meals
- avoid prepared dishes
- use a low salt diet
- walk daily
- weigh daily
- use diuretics as prescribed by your doctor
Avoiding infections after surgery (endocarditis prophylaxis)
(Information for patients who have undergone valve surgery)
If you underwent valve surgery, you should take certain precautions to prevent infective endocarditis. Endocarditis is a serious heart disease. It is an inflammation of the heart tissue. The heart valves are especially sensitive to it. People who have undergone valve surgery should therefore take preventive measures (= prophylaxis). Patients who have had bypass surgery should pay less attention to this.
The symptoms are:
- temperature increase
- general unwellness, feverish
- a murmur at the level of the heart valve
Good prevention consists of:
- good dental hygiene! Research has shown that bacteria in the mouth and the flesh of the teeth can strike the heart valve. Therefore it is recommended to go to the dentist at least every 6 months, even if you have no specific complaints. The teeth should be brushed twice a day, preferably with a soft brush. On the advice of your dentist, mouthwashes may be recommended.
- it is in your best interest to mention the fact that you have undergone valve surgery at every consultation with any doctor or dentist. The doctor can then decide whether you should take antibiotics as a preventive measure.
Any examination you undergo that may cause bleeding should always mention that you have had valve surgery. Do this not only for dental visits but also for invasive examinations and surgical procedures.
If you develop a fever, see your family doctor as soon as possible. It is in the best interest of patients who have undergone valve surgery to consult a doctor as soon as possible if their temperature rises, and not to wait for it to drop spontaneously or to continue rising.
It is recommended that potential sources of infection be avoided. Wounds and injuries should be taken care of properly. Piercings and tattoos are best avoided, as well as unnecessary intravenous administration of medication. In case of bowel problems or hemorrhoids, it is also best to see your family doctor as soon as possible.
What is allowed?
Once your condition has stabilized sufficiently, you can start walking again. This is often the day after surgery. You will be supported by the nurses and physiotherapist. The day after surgery you will also start rehabilitating by walking, cycling or climbing stairs. The goal is to resume normal life as soon as possible. Once at home, you may resume your daily activity. There are no restrictions, but strenuous activity is best avoided for the first few weeks. Lots of walking and cycling is recommended for a quick recovery.
A good and active sex life may be important to you. After heart surgery, starting sexual intercourse again may cause anxiety for you or your partner. The most common fear is that sex would be too strenuous and it could thus cause a heart attack. It doesn’t. You can resume sexual activity as soon as you feel sufficiently recovered.
You should follow a healthy diet for a good recovery but also to keep your heart healthy. You will receive information about this from the dietician during your hospital stay. A loss of appetite is normal in the first period after surgery. If this is the case, try to eat smaller amounts more often.
Driving and traveling
You are not allowed by law to drive for one month after heart surgery. During this period you may ride along in the passenger seat as much as you like. During the postoperative consultation with your attending cardiac specialist it will be assessed whether you can drive again. Also getting on a plane is only permitted again after your check-up appointment with your attending cardiac specialist. He will advise you on travelling.
Return to work
With a minimally invasive procedure, you will be able to return to work sooner. After your check-up with your surgeon and cardiologist, a decision will be made on when you can return to work.
After you are discharged from the hospital, you will be given a number of appointments to come and see your health care providers. It is important to come to these appointments to be sure you are receiving the best possible care that is right for you as an individual.
After about three weeks you will come for a consultation with your cardiac surgeon during which particular attention will be paid to wound healing. A full report of the intervention and of your hospital stay will be sent to your referring cardiologist. An appointment for a postoperative consultation will also be made with your cardiologist. During this checkup, your cardiologist will provide guidance on driving a vehicle, resuming work, and adjusting medication as needed.
A regular checkup with your cardiologist is necessary, at least once a year. Follow carefully the measures your doctor gives you about certain risk factors, such as cholesterol, blood pressure, obesity and smoking.