What to Expect:
o Your child will have on a head wrap. This helps with swelling and prevents a collection of blood from forming.
o Your child will stay in the hospital generally 3-6 days.
o When surgery is done around the eyes, they can become swollen and sometimes be swollen shut for a couple days. The swelling worsens for 2-3 days before it starts to go back down.
o Help hold your child upright or position them so their head is slightly elevated while sleeping. Laying flat will increase the swelling during the first couple days.
o Sometimes the swelling is more in the morning or may be more on one side because of how they were positioned.
o A drainage tube (JP drain) may be used to prevent a collection of fluid under the scalp. This is usually removed 1-2 days after surgery.
Pain Management:
o Some discomfort is expected. The goal is to minimize the discomfort so that it is tolerable. It is unrealistic to expect zero pain after surgery.
o While in the hospital, your child may need some stronger pain medicines. By the time you go home, your child should be comfortable with over the counter children’s Tylenol and ibuprofen.
o Never exceed the maximum daily dose that is described in the over the counter instructions.
Bleeding:
o A small amount of blood is common at the incision site and bandage during the first 1-2 days.
Diet:
o A couple hours after surgery it is very important for your child to start drinking fluid. Depending on the age of the child, this may be with a bottle or a sippy cup.
o Start with clear liquids (water, popsicles, apple juice, tea).
o Sometimes a child may have an upset stomach after surgery. An anti-nausea medication is often given.
o Your child will have an IV that will be giving them fluids to help them stay hydrated.
o It may take several days before they are back to their normal eating habits.
o At home, if you notice fewer wet diapers or urination, please contact our office.
Fevers and Infection:
o A fever during the first 1-2 days after surgery can be very common. It’s the body’s response to undergoing a big surgery and trying to heal.
o Infections are uncommon.
o Signs of an infection include the following:
o Drainage of cloudy or foul smelling fluid from the incision
o A fever that happens after 7 days after surgery
o More redness and swelling after it initially decreases
o If your child’s eyes swell shut a second time
Activity:
o Your child should avoid rough play for a full 6 weeks.
o It may take a couple weeks for them to get back to their normal sleep schedule and energy levels.
o Usually, your child needs to be out of daycare for 4-6 weeks.
Antibiotics:
o Take the prescribed antibiotics as instructed. If your child develops a rash or other side effect, stop the antibiotic and contact our office.
Wound Care:
o Sometimes there is a small tube or drain that helps prevent blood from collecting. This is called a JP drain. At the site where it exits the skin we place some antibiotic ointment. The drain is usually removed 1-2 days after surgery.
o The scalp was repaired with resorbable sutures. They will dissolve/resorb on their own after about 14-21 days.
o The incision site should be kept clean and any dried blood should be cleaned off.
o Dakin’s Solution Quarter Strength (0.125%): apply with a Q-tip to the incision and drain site twice a day for 10 days after surgery.
o Bacitracin ointment should be applied twice a day for the first 5 days. After 5 days, a light coat of Vaseline should be applied for an additional 10 days.
o Gentle shampoo and water can be used. A soft washcloth can be used to pat dry the area.
Medications:
o You should have the following medications at the time of discharge:
o Pain Medications: Tylenol and ibuprofen
o Antibiotic
o Dakin’s Solution Quarter Strength
When to call our office:
o A fever over 101.5 degrees
o If the eyes swell shut a second time
o If there is redness, increased swelling, or drainage from the incision site
o If you cannot arouse your child or he/she is behaving abnormal
o If you don’t feel like the pain is under control
Follow up:
o You will have a follow up appointment about 1 week from the time of discharge.