How many days after abdominal surgery are discharged. Prevention of complications after surgery and rehabilitation - intensive care, nursing care and supervision. How is the postoperative period

Update: October 2018

Hysterectomy or removal of the uterus is a fairly common operation, which is performed according to certain indications. According to statistics, about a third of women who have crossed the 45-year mark have undergone this operation.

And of course, main question, which excites patients who have been operated on or are preparing for surgery, sounds like this: “What consequences can there be after removal of the uterus”?

Postoperative period

As you know, the period of time that lasts from the date of the surgical intervention to the restoration of working capacity and good health is called the postoperative period. Hysterectomy is no exception. The period after the operation is divided into 2 "sub-periods":

early
late postoperative period

In the early postoperative period, the patient is in the hospital under the supervision of doctors. Its duration depends on the surgical approach and the general condition of the patient after surgery.

After surgery to remove the uterus and / or appendages, which was carried out either vaginally or through an incision in the anterior abdominal wall, the patient stays in the gynecological department for 8-10 days, it is at the end of the agreed period that the sutures are removed.
After laparoscopic hysterectomy The patient is discharged after 3-5 days.

First day after surgery

The first postoperative days are especially difficult.

Pain - during this period, a woman feels significant pain both inside the abdomen and in the area of \u200b\u200bthe sutures, which is not surprising, because there is a wound both outside and inside (just remember how painful it is if you accidentally cut your finger). To relieve pain, non-narcotic and narcotic painkillers are prescribed.

lower limbs remain, as before the operation, in or bandaged elastic bandages (prevention of thrombophlebitis).

Activity - surgeons adhere to active management of the patient after surgery, which means getting out of bed early (after laparoscopy after a few hours, after laparotomy after a day). Motor activity "accelerates the blood" and stimulates the bowels.

Diet - the first day after a hysterectomy, a sparing diet is prescribed, in which there are broths, pureed food and liquid (weak tea, non-carbonated mineral water, fruit drinks). Such treatment table Gently stimulates intestinal peristalsis and promotes its early (1-2 days) self-emptying. An independent stool indicates the normalization of the intestines, which requires a transition to regular food.

abdomen after hysterectomy remains painful or sensitive for 3-10 days, depending on the patient's pain threshold. It should be noted that the more active the patient is after the operation, the faster her condition is restored and the lower the risk of possible complications.

Treatment after surgery

Antibiotics - usually, antibacterial therapy is prescribed for prophylactic purposes, since the internal organs of the patient during the operation were in contact with air, and therefore with various infectious agents. The course of antibiotics lasts an average of 7 days.
Anticoagulants - also in the first 2-3 days, anticoagulants (blood thinners) are prescribed, which are designed to protect against thrombosis and the development of thrombophlebitis.
Intravenous infusions- in the first 24 hours after a hysterectomy, infusion therapy (intravenous drip infusion of solutions) is performed to replenish the volume of circulating blood, since the operation is almost always accompanied by significant blood loss (the volume of blood loss in uncomplicated hysterectomy is 400-500 ml).

The course of the early postoperative period is considered smooth if there are no complications.

Early postoperative complications include:

inflammation of the postoperative scar on the skin (redness, swelling, purulent discharge from the wound and even divergence of seams);
problems with urination(pain or cramps when urinating) caused by traumatic urethritis (damage to the mucous membrane of the urethra);
bleeding of varying intensity, both external (from the genital tract) and internal, which indicates insufficient hemostasis during surgery (discharge may be dark or scarlet, blood clots are present);
pulmonary embolism- a dangerous complication that leads to blockage of the branches or the pulmonary artery itself, which is fraught with pulmonary hypertension in the future, the development of pneumonia and even death;
peritonitis - inflammation of the peritoneum, which passes to other internal organs, is dangerous for the development of sepsis;
hematomas (bruises) in the suture area.

Bloody discharge after removal of the uterus by the type of "daub" is always observed, especially in the first 10-14 days after the operation. This symptom is explained by the healing of the sutures in the area of the uterine stump or in the area of \u200b\u200bthe vagina. If the nature of the discharge has changed in a woman after the operation:

accompanied by an unpleasant, putrid odor
the color resembles meat slops

you should immediately consult a doctor. Perhaps there was inflammation of the sutures in the vagina (after hysterectomy or vaginal hysterectomy), which is fraught with the development of peritonitis and sepsis. Bleeding after surgery from the genital tract is a very alarming signal, and requires a second laparotomy.

Suture infection

In case of infection of the postoperative suture, the general body temperature rises, usually not higher than 38 degrees. The patient's condition, as a rule, does not suffer. The prescribed antibiotics and suture treatment are quite enough to stop this complication. The first time the postoperative dressing is changed with the treatment of the wound on the next day after the operation, then the dressing is carried out every other day. It is advisable to treat the sutures with a solution of Curiosin (10 ml 350-500 rubles), which provides soft healing and prevents the formation of a keloid scar.

Peritonitis

The development of peritonitis more often occurs after a hysterectomy performed according to emergency indications, for example, necrosis of the myomatous node.

The patient's condition is rapidly deteriorating
The temperature "jumps" to 39 - 40 degrees
Pronounced pain syndrome
Signs of peritoneal irritation are positive
In this situation, massive antibiotic therapy is carried out (appointment of 2-3 drugs) and the infusion of saline and colloidal solutions
If there is no effect from conservative treatment, surgeons go for relaparotomy, remove the uterine stump (in case of amputation of the uterus), wash the abdominal cavity with antiseptic solutions and install drainage

The performed hysterectomy somewhat changes the patient's habitual lifestyle. For a quick and successful recovery after surgery, doctors give patients a number of specific recommendations. If the early postoperative period proceeded smoothly, then at the end of the woman's stay in the hospital, she should immediately take care of her health and the prevention of long-term consequences.

Bandage

A good help in the late postoperative period is wearing a bandage. It is especially recommended for women of premenopausal age who have had a history of many births or patients with weakened abdominals. There are several models of such a supporting corset, you should choose exactly the model in which the woman does not feel discomfort. The main condition when choosing a bandage is that its width should exceed the scar by at least 1 cm above and below (if a lower median laparotomy was performed).

sex life, lifting weights

Discharge after surgery continues for 4 to 6 weeks. Within one and a half, and preferably two months after a hysterectomy, a woman should not lift weights of more than 3 kg and do heavy physical work, otherwise it threatens with a divergence of internal sutures and abdominal bleeding. Sexual life during the agreed period is also prohibited.

Special exercises and sports

To strengthen the vaginal and pelvic floor muscles, it is recommended to perform special exercises using an appropriate simulator (perineum). It is the simulator that creates resistance and ensures the effectiveness of such intimate gymnastics.

The described exercises (Kegel exercises) got their name from the gynecologist and developer of intimate gymnastics. You need to do at least 300 exercises a day. A good tone of the muscles of the vagina and pelvic floor prevents the prolapse of the walls of the vagina, prolapse of the uterine stump in the future, as well as the occurrence of such an unpleasant condition as urinary incontinence, which is experienced by almost all women in menopause.

Sports after hysterectomy are not burdensome physical activities in the form of yoga, Bodyflex, Pilates, shaping, dancing, swimming. You can start classes only 3 months after the operation (if it was successful, without complications). It is important that physical education in the recovery period is a pleasure, and not exhausting a woman.

About baths, sauna, use of tampons

Within 1.5 months after surgery, it is forbidden to take baths, visit saunas, baths and swim in open water. As long as there is spotting, you should use sanitary pads, but not tampons.

Nutrition, diet

Important in the postoperative period is proper nutrition. To prevent constipation and gas formation, you should consume more fluids and fiber (vegetables, fruits in any form, wholemeal bread). It is recommended to give up coffee and strong tea, and, of course, alcohol. Food should not only be fortified, but contain the required amount of proteins, fats and carbohydrates. Most of the calories a woman should consume in the morning. You will have to give up your favorite fried, fatty and smoked dishes.

Sick leave

The period of incapacity for work in total (including the time spent in the hospital) is from 30 to 45 days. In the event of any complications, the sick leave, of course, is extended.

Hysterectomy: what next?

In most cases, women after surgery face problems of a psycho-emotional nature. This is due to the prevailing stereotype: there is no uterus, which means there is no main female distinguishing feature Therefore, I am not a woman.

In fact, everything is not so. After all, not only the presence of the uterus determines the female essence. To prevent the development of depression after surgery, the issue of hysterectomy and life after that should be studied as carefully as possible. After the operation, the husband can provide significant support, because outwardly the woman has not changed.

Fears regarding changes in appearance:

increased facial hair growth

decreased sex drive

weight gain

voice change, etc.

are far-fetched, and therefore easily overcome.

Sex after hysterectomy

Sexual intercourse will give the woman the same pleasure, since all sensitive areas are not located in the uterus, but in the vagina and external genitalia. If the ovaries are preserved, then they continue to function as before, that is, they secrete the necessary hormones, especially testosterone, which is responsible for sexual desire.

In some cases, women even notice an increase in libido, which is facilitated by getting rid of pain and other problems associated with the uterus, as well as a psychological moment - the fear of unwanted pregnancy disappears. Orgasm after amputation of the uterus will not disappear anywhere, and some patients experience it brighter. But the occurrence of discomfort and even is not excluded.

This point applies to those women who have had a hysterectomy (a scar in the vagina) or a radical hysterectomy (Wertheim's operation), in which part of the vagina is excised. But this problem is completely solvable and depends on the degree of trust and mutual understanding of the partners.

One of the positive aspects of the operation is the absence of menstruation: no uterus - no endometrium - no menstruation. So, forgive the critical days and the troubles associated with them. But it is worth making a reservation, rarely, but in women who have undergone an operation to amputate the uterus with the preservation of the ovaries, there may be slight spotting on the days of menstruation. This fact is explained simply: after amputation, the stump of the uterus remains, and hence a little endometrium. Therefore, you should not be afraid of such allocations.

Loss of fertility

The issue of loss of reproductive function deserves special attention. Naturally, since there is no uterus - a fetus-place, then pregnancy is impossible. Many women put this fact in the column of advantages of a hysterectomy, but if the woman is young, this is certainly a minus. Doctors, before offering to remove the uterus, carefully evaluate all risk factors, study the anamnesis (in particular, the presence of children) and, if possible, try to save the organ.

If the situation allows, the woman either has her fibroids removed (conservative myomectomy) or her ovaries are left. Even with a missing uterus, but preserved ovaries, a woman can become a mother. IVF and surrogacy is a real way to solve the problem.

Suture after removal of the uterus

The seam on the anterior abdominal wall worries women no less than other problems associated with hysterectomy. Laparoscopic surgery or a transverse incision of the abdomen in the lower section will help to avoid this cosmetic defect.

adhesive process

Any surgical intervention in the abdominal cavity is accompanied by the formation of adhesions. Adhesions are connective tissue strands that form between the peritoneum and internal organs, or between organs. Almost 90% of women suffer from adhesive disease after a hysterectomy.

Forcible introduction into the abdominal cavity is accompanied by damage (dissection of the peritoneum), which has fibrinolytic activity and provides lysis of fibrinous exudate, gluing the edges of the dissected peritoneum.

An attempt to close the area of the peritoneal wound (suturing) disrupts the process of melting early fibrin deposits and promotes increased adhesion formation. The process of formation of adhesions after surgery depends on many factors:

the duration of the operation;
the volume of surgical intervention (the more traumatic the operation, the higher the risk of adhesion formation);
blood loss;
internal bleeding, even blood leakage after surgery (blood resorption provokes adhesion formation);
infection (development of infectious complications in the postoperative period);
genetic predisposition (the more genetically determined enzyme N-acetyltransferase is produced that dissolves fibrin deposits, the lower the risk of adhesive disease);
asthenic physique.

pain (constant or intermittent)
urination and defecation disorders
, dyspeptic symptoms.

To prevent the formation of adhesions in the early postoperative period, the following are prescribed:

antibiotics (suppress inflammatory reactions in the abdominal cavity)
anticoagulants (thin the blood and prevent the formation of adhesions)
physical activity already in the first day (side turns)
early start of physiotherapy (ultrasound or, hyaluronidase, and others).

Properly conducted rehabilitation after a hysterectomy will prevent not only the formation of adhesions, but also other consequences of the operation.

Menopause after hysterectomy

One of the long-term consequences of the operation to remove the uterus is menopause. Although, of course, any woman sooner or later comes to this milestone. If during the operation only the uterus was removed, and the appendages (tubes with ovaries) were preserved, then the onset of menopause will occur naturally, that is, at the age for which the woman's body is "programmed" genetically.

However, many doctors are of the opinion that after surgical menopause, menopausal symptoms develop on average 5 years ahead of schedule. Exact explanations for this phenomenon have not yet been found, it is believed that the blood supply to the ovaries after a hysterectomy worsens somewhat, which affects their hormonal function.

Indeed, if we recall the anatomy of the female reproductive system, the ovaries are mostly supplied with blood from the uterine vessels (and, as you know, quite large vessels, the uterine arteries, pass through the uterus).

To understand the problems of menopause after surgery, it is worth deciding on medical terms:

natural menopause - the cessation of menstruation due to the gradual extinction of the hormonal function of the gonads (see)
artificial menopause - cessation of menstruation (surgical - removal of the uterus, medical - suppression of ovarian function by hormonal drugs, radiation)
surgical menopause - removal of both the uterus and ovaries

Women endure surgical menopause more difficult than natural, this is due to the fact that when natural menopause occurs, the ovaries do not immediately stop producing hormones, their production decreases gradually, over several years, and eventually stops.

After the removal of the uterus with appendages, the body undergoes a sharp hormonal restructuring, since the synthesis of sex hormones suddenly stopped. Therefore, surgical menopause is much more difficult, especially if the woman is of childbearing age.

Symptoms of surgical menopause appear within 2-3 weeks after surgery and are not much different from the signs of natural menopause. Women are concerned about:

tides (see)
sweating()
emotional lability
depressive states often occur (see and)
dryness and wilting of the skin later join
fragility of hair and nails ()
urinary incontinence when coughing or laughing ()
vaginal dryness and related sexual problems
decreased sex drive

In the case of removal of both the uterus and the ovaries, it is necessary to prescribe hormone replacement therapy, especially for those women who are under 50 years old. For this purpose, both gestagens and testosterone are used, which is mostly produced in the ovaries and a decrease in its level leads to a weakening of libido.

If the uterus with appendages was removed due to large myomatous nodes, then the following is prescribed:

estrogen monotherapy in continuous mode, used as tablets for oral administration (Ovestin, Livial, Proginova and others),
funds in the form of suppositories and ointments for the treatment of atrophic colpitis (Ovestin),
and preparations for external use (Estrogel, Divigel).

If an adnexal hysterectomy was performed for internal endometriosis:

carry out treatment with estrogen (kliana, proginova)
together with gestagens (suppression of the activity of dormant foci of endometriosis)

Hormone replacement therapy should be started as early as possible, after 1 to 2 months after the hysterectomy. Hormone treatment significantly reduces the risk of cardiovascular disease, osteoporosis and Alzheimer's disease. However, hormone replacement therapy may not be prescribed in all cases.

Contraindications to hormone treatment are:

operation for;
pathology of the veins of the lower extremities (thrombophlebitis, thromboembolism);
severe pathology of the liver and kidneys;
meningioma.

The duration of treatment is from 2 to 5 years or more. You should not expect immediate improvement and disappearance of menopausal symptoms immediately after the start of treatment. The longer hormone replacement therapy is carried out, the less pronounced the clinical manifestations.

Other long-term effects

One of the long-term consequences of hysterovariectomy is the development of osteoporosis. Men are also susceptible to this disease, but the fairer sex suffers from it more often (see). This pathology is associated with a decrease in estrogen production, therefore, in women, osteoporosis is more often diagnosed in periods of pre- and postmenopause (see).

Osteoporosis is a chronic disease prone to progression and is caused by metabolic disorders of the skeleton, such as calcium leaching from the bones. As a result, the bones become thinner and brittle, which increases the risk of fractures. Osteoporosis is a very insidious disease. long time it proceeds hidden, and comes to light in the started stage.

The most common fractures are the vertebral bodies. Moreover, if one vertebra is damaged, there is no pain as such, a pronounced pain syndrome is characteristic of a simultaneous fracture of several vertebrae. Spinal compression and increased bone fragility lead to curvature of the spine, changes in posture and reduced height. Women with osteoporosis are prone to traumatic fractures.

The disease is easier to prevent than to treat (see), therefore, after amputation of the uterus and ovaries, hormone replacement therapy is prescribed, which inhibits the leaching of calcium salts from the bones.

Nutrition and physical activity

You also need to follow a certain diet. The diet should include:

dairy products
all varieties of cabbage, nuts, dried fruits (dried apricots, prunes)
legumes, fresh vegetables and fruits, greens
you should limit the intake of salt (promotes the excretion of calcium by the kidneys), caffeine (coffee, Coca-Cola, strong tea) and give up alcoholic beverages.

Exercise can be helpful in preventing osteoporosis. Physical exercise increases muscle tone, increases joint mobility, which reduces the risk of fractures. Vitamin D plays an important role in the prevention of osteoporosis. The use of fish oil and ultraviolet radiation will help to fill its deficiency. The use of calcium-D3 Nycomed in courses of 4 to 6 weeks compensates for the lack of calcium and vitamin D3 and increases bone density.

Vaginal prolapse

Another long-term consequence of a hysterectomy is omission/prolapse (prolapse) of the vagina.

Firstly, prolapse is associated with trauma to the pelvic tissue and the supporting (ligament) apparatus of the uterus. Moreover, the wider the volume of the operation, the higher the risk of prolapse of the walls of the vagina.
Secondly, the prolapse of the vaginal canal is caused by the descent of neighboring organs into the freed small pelvis, which leads to a cystocele (bladder prolapse) and rectocele (rectal prolapse).

To prevent this complication, a woman is advised to perform Kegel exercises and limit heavy lifting, especially in the first 2 months after a hysterectomy. In advanced cases, an operation is performed (plastic surgery of the vagina and its fixation in the small pelvis by strengthening the ligamentous apparatus).

Forecast

Hysterectomy not only does not affect life expectancy, but even improves its quality. Having got rid of the problems associated with the disease of the uterus and / or appendages, forever forgetting about contraception, many women literally flourish. More than half of the patients note emancipation and increased libido.

Disability after removal of the uterus is not granted, since the operation does not reduce the woman's ability to work. A disability group is assigned only in the case of severe pathology of the uterus, when the hysterectomy entailed radiation or chemotherapy, which significantly affected not only the ability to work, but also the patient's health.

Content

After intervention in the body of a sick patient, a postoperative period is required, which is aimed at eliminating complications and providing competent care. This process is carried out in clinics and hospitals, it includes several stages of recovery. At each of the periods, attentiveness and care for the patient by a nurse, doctor's supervision is required to exclude complications.

What is the postoperative period

In medical terminology, the postoperative period is the time from the end of the operation to the complete recovery of the patient. It is divided into three stages:

early period - before discharge from the hospital;
late - after two months after the operation;
the remote period is the final outcome of the disease.

How long does it take

The end date of the postoperative period depends on the severity of the disease and the individual characteristics of the patient's body, aimed at the recovery process. Recovery time is divided into four phases:

catabolic - an increase in the excretion of nitrogenous wastes in the urine, dysproteinemia, hyperglycemia, leukocytosis, weight loss;
period of reverse development - the influence of hypersecretion of anabolic hormones (insulin, growth hormone);
anabolic - restoration of electrolyte, protein, carbohydrate, fat metabolism;
a period of healthy weight gain.

Goals and objectives

Follow-up after surgery is aimed at restoring normal activities of the patient. The objectives of the period are:

prevention of complications;
recognition of pathologies;
patient care - the introduction of analgesics, blockades, ensuring vital functions, dressings;
preventive measures to combat intoxication, infection.

Early postoperative period

From the second to the seventh day after the operation, the early postoperative period lasts. During these days, doctors eliminate complications (pneumonia, respiratory and renal failure, jaundice, fever, thromboembolic disorders). This period affects the outcome of the operation, which depends on the state of kidney function. Early postoperative complications are almost always characterized by impaired renal function due to the redistribution of fluid in the sectors of the body.

Renal blood flow decreases, which ends on 2-3 days, but sometimes the pathologies are too serious - loss of fluid, vomiting, diarrhea, impaired homeostasis, acute renal failure. Protective therapy, replenishment of blood loss, electrolytes, stimulation of diuresis help to avoid complications. Common causes development of pathologies in the early period after surgery, shock, collapse, hemolysis, muscle damage, burns are considered.

Complications

Complications of the early postoperative period in patients are characterized by the following possible manifestations:

dangerous bleeding - after operations on large vessels;
abdominal bleeding - with intervention in the abdominal or chest cavity;
pallor, shortness of breath, thirst, frequent weak pulse;
divergence of wounds, defeat internal organs;
dynamic paralytic obstruction of the intestines;
persistent vomiting;
the possibility of peritonitis;
purulent-septic processes, the formation of fistulas;
pneumonia, heart failure;
thromboembolism, thrombophlebitis.

Late postoperative period

After 10 days from the moment of operation, the late postoperative period begins. It is divided into hospital and home. The first period is characterized by an improvement in the patient's condition, the beginning of movement around the ward. It lasts 10-14 days, after which the patient is discharged from the hospital and sent for home postoperative recovery, a diet, vitamins and activity restrictions are prescribed.

Complications

There are the following late complications after surgery that occur while the patient is at home or in the hospital:

postoperative hernia;
adhesive intestinal obstruction;
fistulas;
bronchitis, intestinal paresis;
repeated need for surgery.

The causes of complications in the later stages after surgery, doctors call the following factors:

a long period of being in bed;
underlying risk factors – age, disease;
impaired respiratory function due to prolonged anesthesia;
violation of asepsis rules for the operated patient.

Nursing care in the postoperative period

An important role in the care of the patient after the operation is played by nursing care, which continues until the patient is discharged from the department. If it is not enough or it is performed poorly, this leads to unfavorable outcomes and a lengthening of the recovery period. The nurse must prevent any complications, and if they occur, make efforts to eliminate them.

The tasks of the nurse for postoperative care of patients include the following responsibilities:

timely administration of drugs;
patient care;
participation in feeding;
hygienic care of the skin and oral cavity;
monitoring the deterioration of the condition and providing first aid.

Already from the moment the patient enters the intensive care unit, the nurse begins to fulfill her duties:

ventilate the room;
eliminate bright light;
arrange the bed for a comfortable approach to the patient;
monitor the patient's bed rest;
prevent coughing and vomiting;
monitor the position of the patient's head;
feed.

How is the postoperative period

Depending on the condition after the operation of the patient, the stages of postoperative processes are distinguished:

strict bed resting period - it is forbidden to get up and even turn in bed, it is forbidden to carry out any manipulations;
bed rest - under the supervision of a nurse or an exercise therapy specialist, it is allowed to turn in bed, sit down, lower your legs;
ward period - it is allowed to sit on a chair, walk for a short time, but examination, feeding and urination are still carried out in the ward;
general mode - self-service by the patient himself, walking along the corridor, offices, walks in the hospital area is allowed.

Bed rest

After the risk of complications has passed, the patient is transferred from the intensive care unit to the ward, where he should be in bed. The goals of bed rest are:

limitation of physical activation, mobility;
adaptation of the organism to the syndrome of hypoxia;
pain reduction;
restoration of strength.

Bed rest is characterized by the use of functional beds, which can automatically support the patient's position - on the back, stomach, side, reclining, half-sitting. The nurse takes care of the patient during this period - changes linen, helps to cope with physiological needs (urination, defecation) with their complexity, feeds and performs hygiene procedures.

Following a special diet

The postoperative period is characterized by adherence to a special diet, which depends on the volume and nature of the surgical intervention:

After operations on the gastrointestinal tract, enteral nutrition is carried out for the first days (through a probe), then broth, jelly, crackers are given.
When operating on the esophagus and stomach, the first food should not be taken for two days through the mouth. Produce parenteral nutrition - subcutaneous and intravenous intake through a catheter of glucose, blood substitutes, make nutrient enemas. From the second day, broths and jelly can be given, on the 4th add croutons, on the 6th mushy food, from the 10th common table.
In the absence of violations of the integrity of the digestive organs, broths, pureed soups, jelly, baked apples are prescribed.
After operations on the colon, conditions are created so that the patient does not have a stool for 4-5 days. Food low in fiber.
When operating on the oral cavity, a probe is inserted through the nose to ensure the intake of liquid food.

You can start feeding patients 6-8 hours after the operation. Recommendations: observe water-salt and protein metabolism, provide a sufficient amount of vitamins. A balanced postoperative diet for patients consists of 80-100 g of protein, 80-100 g of fat and 400-500 g of carbohydrates daily. For feeding, enteral mixtures, dietary canned meat and vegetables are used.

Intensive observation and treatment

After the patient is transferred to the recovery room, intensive monitoring begins and, if necessary, treatment of complications is carried out. The latter are eliminated with antibiotics, special medicines to maintain the operated organ. The tasks of this stage include:

assessment of physiological parameters;
eating according to the doctor's prescription;
compliance with the motor regime;
drug administration, infusion therapy;
prevention of pulmonary complications;
wound care, collection of drainage;
laboratory tests and blood tests.

Features of the postoperative period

Depending on which organs have undergone surgical intervention, the features of patient care in the postoperative process depend:

Abdominal organs - monitoring the development of bronchopulmonary complications, parenteral nutrition, prevention of gastrointestinal paresis.
Stomach, duodenum, small intestine - parenteral nutrition for the first two days, inclusion of 0.5 liters of liquid on the third day. Aspiration of gastric contents for the first 2 days, probing according to indications, removal of sutures on days 7-8, discharge on days 8-15.
gallbladder- a special diet, removal of drainage, it is allowed to sit for 15-20 days.
Large intestine - the most sparing diet from the second day after the operation, there are no restrictions on fluid intake, the appointment of vaseline oil inside. Extract - for 12-20 days.
Pancreas - preventing the development of acute pancreatitis, monitoring the level of amylase in the blood and urine.
The organs of the chest cavity are the most severe traumatic operations, threatening blood flow disturbance, hypoxia, and massive transfusions. Postoperative recovery requires the use of blood products, active aspiration, and chest massage.
Heart - hourly diuresis, anticoagulant therapy, drainage of cavities.
Lungs, bronchi, trachea - postoperative fistula prevention, antibiotic therapy, local drainage.
Genitourinary system - postoperative drainage of urinary organs and tissues, correction of blood volume, acid-base balance, sparing high-calorie nutrition.
Neurosurgical operations - restoration of brain functions, respiratory capacity.
Orthopedic-traumatological interventions - compensation for blood loss, immobilization of the damaged part of the body, physiotherapy exercises are given.
Vision - 10-12 hours bed period, walks from the next day, regular antibiotics after corneal transplantation.
In children - postoperative pain relief, elimination of blood loss, support for thermoregulation.

Any surgical intervention is stressful for the body. That is why the diet after it should be as varied and correct as possible and contain a sufficient amount of useful substances necessary for a speedy recovery. Moreover, it is not at all difficult to compile it, because most right products can be found in the kitchen of every housewife.

For many of us, food is a source of strength and energy necessary to carry out daily work, but no more. Meanwhile, in fact, ordinary foods are a storehouse of vitamins and microelements that can have a huge impact on our body, including promoting the rapid healing of wounds after operations.

This is happening, according to orthopedic surgeon and author of numerous publications Selena Parekha, “ due to the content in them of special substances with anti-inflammatory and wound healing properties. Thus, including these products in the daily diet, you can quickly return to normal life after surgical interventions.».

Due to the fact that there are several types of operations, it is necessary to draw up a daily menu only together with the attending physician, since he alone knows how the treatment is going and what to be afraid of.

General rules for diet planning

In order for the recovery process to proceed faster, and the person himself does not encounter all sorts of complications, such as constipation or digestive problems, in the postoperative period it is necessary:

1 eat fractionally, but often (5-6 times a day);
2 give preference to whole foods, refusing "processed". In other words, eating an orange instead of orange juice, a baked potato instead of french fries, etc. Simply because processed foods not only lose their beneficial features, but also contain more fat, salt, sugar and all kinds of additives to extend their shelf life. Is it worth talking about what harm the latter can bring to an already exhausted organism?
3 remember fiber. This substance improves digestion and relieves constipation. It is found in cereals, cereals, fruits and vegetables;
4 choose only products with easily digestible protein. It contains essential amino acids that contribute to the rapid healing of wounds and skin regeneration. You can find it in lean meats like chicken, turkey, or lean pork, as well as fish and seafood;
5 refuse solid food in favor of light pureed soups, semi-liquid cereals and broths;
6 Eat only fresh foods, refusing frozen or canned foods in order to get the maximum benefit.

What the body may need after surgery

There are a number of vitamins and minerals that contribute to the speedy recovery. This:

Vitamin C . After the operation, its reserves in the body are quickly depleted, since during this period the immune system tries to prevent the development of any diseases and struggles with pathogenic microorganisms. However, regular consumption of foods with vitamin C not only restores the body's defenses, but also allows it to more actively produce collagen, which is necessary for skin regeneration.
Vitamin A . Takes part in the formation of connective tissue components, promotes skin regeneration.
Zinc is a mineral that boosts immunity and promotes faster healing of wounds.
Iron - it is responsible for the formation of red blood cells and the optimal level of hemoglobin in the blood. Its deficiency leads to anemia, or anemia, while its content in the diet leads to a quick recovery.
Vitamin D - ensures the growth and development of bone tissue.
Vitamin E - protects cells from toxins, has antioxidant properties.
Vitamin K is responsible for blood clotting.
Folic acid - takes part in the formation of red blood cells. The body especially needs it after strip operations.
Phosphorus - doctors can prescribe it after stomach or kidney surgery. In the latter case, for example, in the postoperative period, the body actively restores bone mass lost as a result of kidney failure, using more phosphorus than usual. In order to avoid problems associated with its lack, you need to increase the number of foods with its content in your diet.

Top 12 Fast Recovery Foods

Almonds are a source of vitamin E and an essential mineral needed for rapid wound healing.

Beans are a source of iron, on which the formation of red blood cells depends.

Chicken breast- a source of protein responsible for the growth and development of muscle tissue, which is damaged after surgery and requires restoration.

Citrus fruits are a source of vitamin C, which is involved in the process of collagen production and skin regeneration.

Sweet pepper is a source of vitamins A, C, E and fibrin, which are actively involved in the process of skin regeneration.

Ginger - contains not only vitamins and microelements, but also gingerol, which improves blood flow and metabolic processes, including in the damaged area of the body, due to which the wound healing process is faster.

Water ensures the functioning of all organs and systems, reduces the feeling of nausea and fatigue, relieves dizziness, and also removes toxins from the body that are formed as a result of inflammation in the wound after surgery. You can replace it with green tea, dried fruit compote, rosehip decoctions and jelly. Meanwhile, the amount of water drunk per day should be determined by the doctor, based on the type of operation and its course.

After the operation, the diet should be as gentle as possible for the digestive organs, and, at the same time, provide the weakened body with all the necessary nutrients. The patient after surgery needs complete rest - the body needs strength for further recovery and normal functioning.

What should be the diet after surgery?

The diet after surgery depends, first of all, on which organs the surgical intervention was performed on. Based on this, the entire further diet and diet of the patient is built.

However, there are general rules for postoperative nutrition, taking into account the functioning of the body of operated patients (weakness of the gastrointestinal tract, increased need for proteins, vitamins and trace elements). These recommendations are basic and are used for all diets after surgery:

Sparing food. Due to the fact that after operations, the load on the digestive organs is undesirable (and, in many cases, impossible), the dishes should be liquid, semi-liquid, jelly-like or creamy grated consistency, especially on the second or third day after surgery. The use of solid food is contraindicated;
The first day after the operation, only drinking is recommended: mineral water without gas, ordinary boiled water;
As the patient recovers, the diet after the operation is expanded - thicker food is introduced and some foods are added.

Diet after surgery for the first 3 days

What should be the diet in the first few days after the operation? Let us dwell on this issue in more detail, since nutrition in the first postoperative period is the most difficult.

After the operation, the patient's diet for the first 2-3 days consists only of liquid or frayed dishes. The temperature of food is optimal - not higher than 45 ° C. The patient is given food 7-8 times a day.

There are clear medical prescriptions for the use of dishes: what is possible and what is not possible with a diet after surgery is indicated in them quite accurately.

What can be done with a diet after surgery (the first few days):

Diluted low-fat meat broths;
Mucous decoctions with the addition of cream;
Rice broth with butter;
Rosehip decoction with honey or sugar;
Strained fruit compotes;
Diluted juices 1:3 for a third of a glass for one meal;
Liquid kissels;
On the third day, one soft-boiled egg can be introduced into the diet after the operation.

What not to eat after surgery:

The diet after the operation excludes carbonated drinks, whole milk, sour cream, grape juice, vegetable juices, coarse and solid foods.

An example of a diet menu after surgery for the first 3 days

Warm tea with sugar - 100 ml, sparse berry jelly - 100 g;

Every two hours:

Strained apple compote - 150-200 ml;
Low-fat meat broth - 200g;
Rosehip broth - 150 ml, jelly - 120 g;
Warm tea with sugar and lemon - 150-200 ml;
Slimy cereal decoction with cream - 150-180 ml, fruit jelly- 150g;
Rosehip decoction - 180-200 ml;
Strained compote - 180 ml.

After the initial light diet after surgery, transitional restorative nutrition is prescribed, aimed at a gradual transition to a full diet.

What is possible and what is not in the diet after surgery on days 4.5 and 6

After the first three postoperative days, liquid or pureed cereals from buckwheat, rice or oatmeal are introduced into the diet. It is allowed to use cereal mucous soups and meat broths with the addition of semolina, steam omelettes. You can expand the diet with meat or fish steam soufflé, sweet mousses and milk cream.

It is forbidden to eat too dense and dry food, as well as fresh fruits and vegetables (due to the high content of fiber, which stimulates the contraction of the stomach).

In the following days and until the end of the recovery period, steam dishes from cottage cheese, baked apples, vegetable and fruit purees, sour-milk liquid products (kefir, fermented baked milk) are added to the diet menu after the operation.

diet after appendicitis

The recovery period after appendicitis surgery is about two weeks. All this time, you should adhere to a special diet, which in the first days will help the body recover and gain strength, and in the subsequent days it will allow you to fully eat without burdening the weakened gastrointestinal tract.

In the first 12 hours after the operation, eating is prohibited, but there is usually no appetite at this time. Further, for 3-4 days, the diet after appendicitis recommends eating the following dishes:

Low-fat broths;
Rosehip decoction with sugar;
Black tea with sugar;
rice water;
Jelly, diluted 1:2 fruit juices, jelly.

The diet after appendicitis prescribes to give up whole milk and any solid food for the first 3 days.

On the 4th day of the diet after the operation to remove the appendix, fresh soft fruits (bananas, peaches, grapes, persimmons) and vegetables (tomato, cucumber) are introduced into the diet. To replenish a weakened body with protein, steam dishes from cottage cheese (soufflé, casseroles), boiled meat and fish are prepared. It is useful to introduce fermented milk products (kefir, fermented baked milk, yogurt), boiled or vegetable stew(zucchini, cabbage, eggplant), butter, low-fat cream.

Foods that are contraindicated in the diet after appendicitis:

Carbonated mineral and sweet water;
Rich meat broths;
Dough products, white bread;
Canned food and smoked meats;
Hot spices and seasonings;
Cakes, cookies, sweets.

The diet after the operation is based on the principle of fractional nutrition - you need to eat often, in small portions. You can not drink food with water or tea, you need to wait an hour and a half so that the food begins to be absorbed and does not stick together in a lump from the incoming liquid.

Important dietary tips after surgery

During surgery on the esophagus or other organs of the gastrointestinal tract, it is forbidden to eat food through the mouth in the first 2-3 days - feeding is done through a probe. Further, the diet after the operation follows the usual scenario.

A frequent problem after surgery is difficulty in the natural emptying of the intestines. Constipation can be caused by postoperative adhesions or scars, weak activity of the stomach after an abundance of mashed dishes, general weakness of the body.

In this case, you should enter into the diet menu after the operation products that enhance intestinal motility (if there is no doctor's ban): kefir, softened prunes, grated raw carrots and an apple.

Recommended set of exercises (one month after surgery)

At first, do 1 to 5 repetitions of exercises 2 times a day, increasing to 10 repetitions of each exercise 2 times a day.
Perform exercises smoothly and slowly, without sudden movements. If during execution you feel discomfort or pain, then do not do this exercise for a while. If such sensations become persistent, you should consult a doctor.
The intensity of the load depends on how you feel. As soon as pain appears, reduce the intensity of exercise.

Exercise 1. Lie on your back. Slowly bend your knees and press to your chest, feel the tension in the gluteal muscles. Relax the gluteal muscles. Keep your legs bent for 45-60 seconds, then slowly straighten them.

Exercise 2. Lie on your back, bend your knees, hands on the floor in different directions. Raise your pelvis off the floor and hold for 10-15 seconds. Adjust the holding time to 60 seconds.

Exercise 3. Lie on your back, hands behind your head, legs bent at the knees. Turn your legs alternately, first to the right, then to the left, touching the floor with your knee; the upper body remains in a horizontal position. Hold your legs in a rotated position for up to 60 seconds.

Exercise 4. Lie on your back, bend your knees, cross your arms over your chest, press your chin to your chest. Tightening the abdominal muscles, bend forward and hold in this position for 10 seconds, then relax. Repeat 10 to 15 times, gradually increasing the number of repetitions.

Exercise 5. Starting position on the hands and legs bent at the knees. Simultaneously left leg and right hand pull horizontally and lock in this position for 10 to 60 seconds. Repeat by raising your right arm and left leg.

Exercise 6. Starting position: lying on the stomach, arms bent at the elbow joints, lie near the head. Straightening your arms, lift your upper body and head up, bending in the lumbar region, while keeping your hips off the floor. Hold this position for 10 seconds. Get down on the floor and relax.

Exercise 7. Starting position lying on the stomach, hands under the chin. Slowly, low, lift your straight leg up without lifting your pelvis off the floor. Slowly lower your leg and repeat with the other leg.

Exercise 8. Starting position: stand on one leg, the second, straightened, put on a chair. Leaning forward, bend the knee of the leg lying on the chair, and hold in this position for 30-45 seconds. Straighten up and return to the starting position.