WHAT TO EXPECT AFTER SURGERY?

• The surgery usually lasts about an hour. You will be able to go home after the surgery. Make sure you have someone with you to drive you home and go over postoperative instructions.

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• You will have a drain (a plastic drainage tube) that comes out from the skin at the top of where the surgery was done. This typically stays for 6-7 days depending on the amount of drainage. The tube will be attached to a rubber bulb for suction. The nurses will show you how to empty this and attach it back. Please record the amount of drainage every 12 hours. Typically, the tube will be removed once the drainage is less than 15 ml/day for 2 days and the drainage is clearing. You will be on oral antibiotics during some of the time you have the drain (5 days). In some cases, Dr. Wadie will offer to remove the drain in the office. Most of the times, specially for patients coming from out of town, you can remove the drain yourself at home. Instructions will be provided. Here is a video to show you how to remove the drain.

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• Pain after surgery is usually minimal. Most patients require only ibuprofen every 6 hours for pain control alternating with Tylenol. We will give you a prescription for stronger pain medicine with narcotics to be taken as needed. Most patients will only need this for 2-3 days.

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• You will have a gauze dressing over the wound with tape to keep the dressing in place. The tape is open at the bottom to allow for bowel movements. Underneath the gauze, the wound is covered by Steri-strips to hold the skin edges together. The wound itself is closed by dissolvable sutures under the skin. Remember, no open wounds or packing. Keep the dressing intact till your first visit with Dr. Wadie or till the drain is ready to come out if you are removing it yourself.

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• Your first postoperative visit will be 6-7 days after surgery. During this visit, Dr. Wadie will remove the drain. He will also remove the gauze dressing and ask you to paint the wound once daily with an antiseptic solution called Betadine. This keeps the wound clean and dry. If you opt to remove the drain yourself, this visit is not needed. You can share pictures of the wound with Dr. Wadie through our secure email and he will let you know what to do.

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• Your second visit will be 2 weeks after surgery. Most of the time, the Steri-strips will have fallen off already leaving a clean linear thin scar. This is normal. For those from out of state, again, you can email us pictures and do not need to come back.

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• Keep the wound dry until the drain is out. You can have a shower 24 hours after the drain is removed with nothing covering the wound except the steri-strips. No sitting in water or swimming until 2 weeks after surgery. If you want to have a shower before the drain is out, you can either have a sponge bath or cover the whole area with water proof bags and make sure the dressing does not get wet.

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• Once the dressing is removed, you or someone will need to paint the wound with an antiseptic solution called Betadine. Get a piece of gauze wet with Betadine and paint the wound daily from top to bottom. Make sure to cover the steri-strips with the Betadine and paint the lowermost part of the wound well. Let the Betadine air dry and then put on normal cloth or cover with a small piece of gauze to avoid staining your cloth. At this point, no bulky dressing or tape are needed. It is advisable to keep a small piece of rolled gauze tucked inbetween the buttock cheeks over the lower part of the incision at all times for the first 1-2 months after surgery. This helps wick any moisture and minimize skin to skin friction in that area. If the gauze gets soiled with drainage from the wound or stool, it can be easily replaced.

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• Activity: Most patients will be able to sit and resume regular activities the day after surgery. If you are taking narcotics, it is not advisable to go back to school, work or drive till you stop taking . Most children can go back to school 3-4 days after surgery. Adults can go back to work in about a week. You should avoid squatting, bending over from standing, bike riding, sliding, contact sports or direct falls on the buttock area until the second postoperative visit. All activities can be resumed in 2 weeks. Remember, the cleft lift procedure has the quickest recovery.

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• Constipation: is common after any surgery, particularly if you are taking narcotics. If you do not have a bowel movement 2 days after surgery, you can take a laxative (Miralax or Senna products). Keep the area around the incision clean and paint with Betadine.

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• Symptoms to look for after surgery include fever higher than 102 degrees, severe pain at the operative site, increased drainage or milky (white, green, yellow) drainage from the wound. Please call our office if you develop any of these symptoms.