Definition and Overview

Also known as post-operative care, a surgical follow-up is a routine procedure carried out immediately after the surgery and typically extends for a few days or months until the patient has fully recovered.

There are many reasons why patients have to undergo surgical procedures; regardless of the extent and the degree of complexity of the surgery, it always carries a certain amount of risk, such as:

  • Pain and discomfort – While anesthesia is administered before the procedure to minimize pain and discomfort, they can return once the effects of the drug have worn off. Sometimes the level of pain can be so severe that it affects the movements and limits the activities of the patient.

  • BleedingBleeding around the wound site is likely, especially when sutures or stitches are not performed well or when the patient has accidentally removed them for some reason. While not all types of bleeding are dangerous, there are cases that result in massive blood loss and threaten the death of important tissues. Such cases require immediate medical attention.

  • Infection – Another common surgical complication is infection, which can develop due to pathogens present in the health care facility.

The surgical follow-up is designed to make the recovery process as convenient and as quick as possible by:

  • Reducing or eliminating the risks and complications
  • Teaching the patient about wound care and post-surgical management
  • Anticipating the possible needs of the patient
  • Conducting therapies to help patients become more independent
  • Monitoring the progress of healing

Who Should Undergo and Expected Results

Post-operative care is expected for patients who:

  • Underwent surgery, especially if the procedure is considered complex or very risky

  • Received a transplanted organ: transplant patients are considered high-risk for a number of reasons. First, their immune system is usually low or compromised particularly a few days or weeks after surgery. Second, they run the risk of developing organ rejection, in which the body’s immune system attacks the newly transplanted organ, causing severe irreparable damage.

Post-operative care is expected to be carried out as soon as the patient has undergone the surgery. Depending on the kind of surgery, however, it can extend for many days or weeks. Sometimes it can last for a couple of years. For example, patients who have undergone hip and knee replacement surgeries are continuously monitored to ensure that the risk of a heart attack within a year after the treatment does not increase.

How Does the Procedure Work?

Surgical follow-up can be performed both on an inpatient and outpatient setting. The latter is because the surgery may be minor that the patient does not have to be confined, or the surgery may be complex that surveillance and administration of care should be implemented even when the patient is already out of the hospital. Post-operative care is headed by the patient’s surgeon with the help of other health providers who carry out certain tasks such as monitoring the vital signs or dressing the wound.

Some of the most common post-operative procedures are:

  • Administration of medication to minimize pain and discomfort, speed up the recovery, and relax the patient

  • Surveillance or close monitoring - this means that the surgeon does not do anything unless intervention is absolutely necessary. Rather, he focuses on making sure that the wound is healing as expected.

  • Education, in which the surgeon provides the necessary information so the patient can take a proactive approach to healing. This includes information on how to clean and protect the wound, how to detect possible infection, what to eat, the activities that he can pursue or needs to avoid while still in recovery, how to increase mobility, the therapies he might need to undergo to restore body function, and medications to take once he is already at home.

  • Nutrition - The surgeon typically works closely with a dietitian who can create a meal plan for the patient based on the condition he has or the type of surgery he has gone through. The patient will also be educated as to what types of food and drink must be avoided especially during the first few hours or days after surgery.

  • Counseling among family members - Patients tend to do better if they receive support from their immediate families, who can also act as caregivers while the patient is recovering. The counseling is helpful in preparing the family for the possible changes that may occur while the patient is recovering.

  • Systemic management: Surgical follow-up is concerned not only on the organ that has been operated on but the person’s overall health as well. Hence, management also covers other systems, particularly cardiovascular, urinary, and respiratory systems.

In an outpatient setting, many health providers are now relying on new technologies such as teleconferencing. In this scenario, doctors make a follow-up by making a video call using tools such as Skype. This procedure now allows physicians to cover more patients at any given time and keep track of their progress even when they are on the road.

Possible Risks and Complications

Surgical follow-up does not guarantee that the patient won’t have any risk. This simply suggests that a patient can still develop infection, organ rejection, bleeding, and respiratory problems, which may place his life in danger. However, a medical team who’s experienced and knowledgeable in post-operative care should know how to immediately intervene, mitigate the risks, and help the patient recover from these setbacks.

References:

  • Anderson, D.J. Surgical site infections. Infect Dis Clin N Am. 2011; 25(1): 135-153.

  • Kulaylat MN, Dayton MT. Surgical Complications. in: Townsend CM, Beauchamp RD, Evers BM, Mattox, KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 13.

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