Chest surgery home care (1277)

General Guidelines

• For the first 2 weeks after surgery it is very important that your child stay away from people who are or may be sick.
• For the first 2 weeks after surgery persuade your child to nap or rest often.

Activities

Infants and young children

• Your child should always ride in the back seat, especially after surgery. Do not change any car seat restraints.
•  For 6 weeks after the surgery:
  - When moving or lifting your child, lift their head, bottom, and back (scoop technique). Do not lift your child under the arms.
  - Do not pull your baby or child up by the arms or pull on your child’s arms. This may disrupt healing.
• Once cleared by your physical or occupational therapist, do tummy time with your baby. This is often a few days after surgery.

Older Children

For 6 weeks after surgery:

• Your child should ride in the back seat of the car.
• Your child should nap or rest when they are tired.
• If the weather is nice, your child can go outside.
• Your child should do their shoulder exercises daily. This will make sure that their shoulders do not get stiff.

Restrictions:

• Limit any strenuous exercise.
• Things to avoid:
  - Contact sports, bike riding, or activities that could cause impact to the chest or pulling on the incision.
  - Lifting anything more than 5 pounds (including book bags). A 2L bottle of soda weighs about 5 pounds and a gallon of milk weighs about 8 pounds.
  - Using a backpack. It may help to have 2 sets of books (one for home and one for school). They may ask for a friend to be assigned to help carry books and supplies.
  - Swimming for 6 weeks after surgery or longer. Chest tube sites must be scabbed over and healed.
  - Driving for at least 1 week after surgery. They should not drive if they are taking sedative drugs or pain medicine.

Incision care

• Five days after surgery, your child may take a quick 5 minute shower. They may start longer showers 2 weeks after surgery.
• For the first 2 weeks after surgery, your child may take a bath in a little water but may not let the incision go under water. (No soaking baths or swimming for at least 2 weeks).
• Check the incision every day for signs of infection. This include redness, warmth, swelling, or thick, cloudy drainage.
• The incision may be cleaned with soap and water. Pat dry with a towel.
• Steri strips may be removed 10 to14 days after surgery. You can do it at home or ask for them to be removed at follow up with cardiology.
• There may be ends of suture under the steri strips that will be cut close to the skin.
• Chest tube sites will scab over. If the scab comes off and there is bleeding or drainage, clean with betadine or hydrogen peroxide. Cover with a dry gauze dressing. When the scab forms
  again, remove the dressing.
• Do gentle circular massage to chest tube sites 4 to 6 weeks after surgery. This helps to keep chest tube sites from pulling inward. This massage it not to be done on the sternal incision,
  only chest tube sites.
• Lotions and ointments should not be used on the surgical sites for at least 6 weeks after surgery.

Medicine Schedule

Your health care team will go over your child’s medicine before you go home.

Follow up

Your child will need to see their primary care doctor about one week after leaving the hospital. They may also need to see their cardiologist or surgeon. The After Visit Summary will have instructions. New activity guidelines may be given at that visit.