Postoperative Care | The University Of Western Ontario

University:
The University Of Western Ontario
Course:
Biology 2290F | Scientific Method in Biology
Academic year:

2022
Views:

43

Pages:

2
Author:

Kyuwon J.

Postoperative Care ● Stage 1 ○ Immediate postoperative phase (0-2 weeks) ■ Goal ● Protect surgical repair/ fixation ● Prevent infection ○ hematoma ○ vascular compromise ● Controlling pain and edema ● Gentle mobilization on uninvolved joints ■ Key interventions ● Wound and dressing ○ Sterile dressing ■ Compressment on support ○ Elevation on limb ■ Above heart ■ minimization of edema ○ Inspecting dressing daily ■ Must check for bleeding ■ Tightness on dressing is also critical ● Pain and inflammations ○ Paracetamol ○ NSAID ○ Short course opioids and major bones ○ Cryotherapy needed ● Infection prophylaxis ○ IV cefazolin ○ Strict asepsis on dressing changes ● Stage 2 ○ Early rehabilitation phase (2-6 weeks) ■ Goals ● Protection on healing tissues ● Prevention on joint stiffness ● Restoration of tendon tissues ● joint mobility normalizing ■ Expected outcomes ● development of tendon vascularization ○ 3 week post graft ● Decrease in swelling - minimizing pain ● prevention on contractures ● Prevention on contractures ● Controlled movement is possible at this stage ○ No jeopardizing ● Stage 3 ○ Functional Strengthening phase (6-12 weeks) ■ goals ● regaining on functional ROM ● Restoring propricioception ● residual stiffness ■ Interventions ● Therapy Progressions ○ transition passive => fully active ROM ○ Initiation isometric => isotonic => resisted exercise ■ use therapy putty, elastic bands ○ introduction of functional grip tasks ● Soft tissues agements ○ continuation of deep tissue massage ■ prevention of adhesions ○ Ultrasound therapy is needed once indicated stiffness ● Occupational Training ○ education on daily tasks ○ fine motor retaining ■ Outcomes ● increase in grip and pinch strength ○ 60-80% of contralateral sides ● passive, fully active ROM ● independence of ADL ● Stage 4 ○ Late rehabilitations + long term follow up (3 month to 1 year) ■ Goals ● optimization on strength, and endurance ● prevention of long term complications ● Evaluation on surgical success and patients’s status ■ Outcome ● 90 -100% restoration on pre-injury functions ● full tissue healing with stable joints ● improving aesthetic and functional outcome ○ excellence in dorsal contour + motion in 1 year follow-up in case of constriction ring release ● long term goal is to have patient satisfaction and pain free activity.