The recovery from a minimally invasive parotidectomy is remarkably rapid, predictable, and simple. Despite the fairly routine after care instructions, each person is unique and as such is their postoperative experience. In the following we offer a brief overview of the typical postoperative course.
WHEN YOU AWAKE FROM SURGERY
A formal parotid dressing will be present when you awake from your surgical procedure. In addition to the parotid dressing, there may exist a plastic drainage tube depending on the extent of your surgery.
POSTOPERATIVE DAY 1
If you have a drainage tube it will likely be removed the first day after surgery. At that time your head dressing will be removed and the surgical site will be inspected. At that time a more comfortable parotid compression dressing will be applied and it will remain for 48 hours.
POSTOPERATIVE DAYS 2-3
Nothing to do but enjoy the fact that surgery is over!
POSTOPERATIVE DAY 4
The parotid dressing will be removed on the 4th day after surgery. This dressing can be removed by anyone. If you have ever unwrapped a gift you are qualified to remove this dressing. The majority of our patients are back in the comfort of their own home when this dressing is removed. After the parotid dressing is removed the surgical site will be open to the air. It is not necessary to cover the incision. During this time period the incision should be kept dry. Twice a day a thin coat of an over-the-counter antibiotic ointment such as bacitracin or polysporin should be applied. Avoid Neosporin as this medication causes rash in many patients after long-term use.
POSTOPERATIVE DAYS 5-7
Between day 5 and day 7 after surgery the sutures should be removed. The sutures are put in using a simple running technique. These are removed by just cutting and pulling. Steri-strips may be applied afterwards if desired.
As with removing the dressing, removing the sutures does not require a medical degree, however most patients do have a local healthcare provider remove the sutures.
SHORT TERM WOUND CARE
These instructions should be carefully read and followed. They are designed to answer the most commonly asked questions regarding post-operative care. We hope this information will help you during the post-operative period. Remember to call on us if you have any questions, as our concern is to give you the best possible care.
ACTIVITY: THE FIRST WEEK
Limit your activity over the first week following surgery. You are encouraged to walk about the house or outside carefully several times per day. Avoid unnecessary bending at the waist and picking up heavy objects that weigh more than 20 lbs. When you rest or sleep, keep your head elevated on 2-3 pillows.
Smoking should be avoided, as it interferes with and slows subsequent healing. If you cannot completely stop smoking, cut back to a minimum. Alcohol consumption should also be limited. If oral antibiotics have been prescribed, it is very important that you take them.
You may shower after 48 hours, but should keep the water from directly contacting your incision site. You may carefully wash your face with a mild soap (Neutrogena) and a clean washcloth, or cotton balls.
Washing your hair is permitted 72 hours after surgery. Avoid irritating any of the incision lines. Keep them from crusting with a light coating of prescribed ointment or pure petroleum jelly.
Pain medications are prescribed as needed. Take them only as needed. After the first 24 hours, Extra-Strength Tylenol may be sufficient. Remember, pain and sleep medications may impair your reactions, so avoid driving or other hazardous activities for 24 hours after taking them. If the prescribed medications do not control your symptoms, please call us. Nausea may occasionally be related to the above medications. Small amounts of clear fluids at frequent intervals may help. If this is not effective, call us.
LONG TERM WOUND CARE
ACTIVITY AFTER THE FIRST WEEK
You may slowly resume your activities beginning after the first week. Let your body tell you how much to do. Light exercise is permitted after 2 weeks. Moderately strenuous exercise may be resumed in 4-6 weeks. Build up to this level slowly. You may begin by walking or other similar light exercise. In any event, do not strain or do anything of sufficient exertion to cause your pulse rate to sharply increase. Avoid excess sunlight. Even a mild sunburn may cause prolonged swelling or irritation of the healing incisions. Do not compare your progress with that of other patients. Remember that everyone heals in his/her own unique way. Also, if you have any questions or concerns, call us. Your family and friends mean well, but we can provide better information.
Incisions take approximately 6 weeks to heal, however they continue to remodel for one to two years after surgery. Initially during the first 6 weeks scar creams should be used to hasten the initial healing. After this time sunscreens are worn daily for at least one year directly on the incision site to prevent hyperpigmentation or prolonged redness.
You will go home with oral antibiotics and pain medication. Most patients only use the pain medication for the first 24 hours and then only require Tylenol or Motrin. The antibiotics are prophylactic and are not mandatory to take postoperatively as they are given throughout the surgical procedure.
In general, you will be able to eat a regular meal for dinner after your surgery. However, a light meal is preferable. Certain foods activate and increase parotid gland activity. We wish to rest the parotid gland after surgery and thus ask you to avoid all citrus fruit such as limes, lemons, grapefruits, or oranges for 6-8 weeks following surgery.
The surgical specimen will be sent for microscopic analysis after it is removed. When the results of your pathology are available Dr. Osborne will contact you and discuss the results with you in detail.
Upon your request, Dr. Osborne will discuss your case with your local doctors and forward all pertinent records to them.
We recommend an MRI of the neck with gadolinium 3 months after your surgery to be used for long term follow-up, as well as a bi-annual physical exam with your local ENT physician.
Dr. Osborne and Dr. Hamilton as well as the entire OHNI staff will remain available to you indefinitely.
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