Recovery after abdominal surgery, gynecological. Nutrition, diet, exercises, joint, rehabilitation, bandage

Abdominal surgery - surgery conducted by a front wall section of the sternum or abdominal cavity. It indicated in serious injuries leading to the internal rupture of internal organs, acute exacerbations of chronic pathologies.

Properly organized a course of rehabilitation activities carried out in the postoperative period, contributes to the full recovery of the body.

The essence of abdominal surgery

Abdominal surgery performed in emergency and planned manner.

Depending on the disease, the severity of the inflammatory process are different:

1. laparotomy - interference, in which the surgeon cuts through the peritoneum, the chest to detect the source of bleeding, remove the diseased organ. Carried out in an emergency. Very traumatic, it requires a long recovery period.
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2. Laparoscopy - appointed in a planned manner, in the absence of an acute inflammation of internal bleeding. The essence of the operation is to remove the affected area with plastic tubes, placed in small incisions. surgeon action projected onto a monitor. This technique is less traumatic tissue, accompanied by low blood loss. The patient is able to return to normal life after 7-10 days after surgery.

Features postoperative rehabilitation

Recovery after abdominal surgery includes recommendations for the care and behavior of the patient, promoting rapid healing of the injured area, the normalization of internal systems functions body.

the following recommendations:

1. Ensuring free access of air (frequent airing) in the recovery room.
2. Special drinking regime. During the surgical procedure, there is a large loss of fluid in need of a quick recovery. Beginning the first day after the operation the patient should consume from 2 to 4 liters of pure water.
3. For the first time after surgery, the patient should take a horizontal position. In the case of cutting the sternum or peritoneum should lie on his back, raised headrest. Operation of the spine requires adherence to a horizontal position.
4. Motor activity begins after the permission of the attending physician. In most cases, it is recommended to try to get up to 3-4 days after surgery. Movement of the limbs and body to help prevent pressure ulcers, intestinal adhesions, thrombus formation.
5. Breathing exercises shown with the 1st day of the postoperative period. Patients should be every 45 minutes a deep inhale and exhale air. Exercises are used to prevent fluid retention in the lungs (pneumonia prophylaxis).
6. Upon termination of the patient's anesthesia start to disturb in joint pain and injured cavity. To remove the spasms are appointed painkillers. By incision site is exerted heater filled with cold water or ice.
7. To prevent infection, festering joint first 5-7 days after surgery an antibiotic is prescribed.
8. Sutures are removed 8-10 days. Until that time, the incision site can not be wetted. Within 2 weeks prohibited water treatments requiring complete submersion. With 4 days is allowed to take a shower, Wipe with a damp towel. Place seam is necessary to cover waterproof bandage or plaster.
   
9. Abdominal surgery requires compliance with diet. In the 1 st day after the procedure is prohibited to use any food. 2-3-day show, liquid soups, porridges. The list of authorized food defines the surgeon depending on the disease. All patients who have experienced abdominal operation, prohibited the consumption of fatty, fried, spicy, salty foods, carbonated lemonade.
10. The operated state (body temperature, blood cell count and urine, general health, blood pressure) are closely monitored during the first 4 days. In case of intoxication, coordination disturbances, seizures carried out emergency medical assistance.
11. To avoid festering seam region 1 time per day is carefully processed brilliant green. On incision bandage or patch.

timing recovery

Recovery after abdominal operation - long rehabilitation process, conditionally divided into three periods:

1. Early - the time interval beginning from the moment of closure of the surgical procedure and continuing until the removal of stitches (8-10 days).
2. Late - varies depending on the severity of the disease. It extends in a medical hospital, includes the time during which the patient is in a post-operative or rehabilitation chamber (after removal of sutures and the time of the extract). Patients who had laparoscopy, appendectomy are given time to outpatient treatment.
3. Remote - the period required the patient to fully recover and return to normal life.

The duration of the rehabilitation period varies depending on:

• the patient's age;
• presence in the body concomitant chronic pathologies;
• of the immune system;
• patient weight;
• the quality of the blood supply to the injured area of ​​the body.
• method of operation;
• excised volume area;
• measures used to prevent postoperative joint infections.

Extensive abdominal surgery (especially held in an emergency) on the abdomen requires a long recovery period.

The seam is removed for 10-12-th day. To return to normal activities must have at least 2, 3 months of gentle treatment. The laparoscopic technique, appendectomy, elective surgery differ less trauma to the internal organs and tissues. Threads are removed for 8-10 hours. The recovery period is from 2 weeks up to 1.5 months.

Excision of the thorax (operations associated with cardiovascular pathologies) needs a long rehabilitation period. Within 6 months the patient is shown holding a reparative therapy. Seams completely heal in 3-4 weeks.

Methods for recovery after surgery

Recovery after abdominal surgery involves the use of drugs, complex special exercises supplemented massage, therapeutic diet, physical therapy:

Medications

Table:

Characteristics of drugs	effect	used drugs	Dosage treatment
antibiotic therapy	It aims to prevent hospital infection by Staphylococcus aureus, Pseudomonas aeruginosa, enterocolitis.	cephalosporin series (Tsefatoksin, cefazolin); penicillins (Amoksiklav); meropenem; Amoxicillin.	Assigned / o or w / w. Prescribed by 0.25-1 g every 12 hours for 7-10 days.
analgesics	They are used to relieve severe pain after surgery	Narcotic drugs (Morphine, promedola Tramadol)	Only in the case extensive surgery, removal of cancer tumors. Eliminate any pain for a period of 5 to 8 hours.
Narcotic antispasmodics, designated in the early postoperative period (diclofenac, nimesulide, Rofenoksif). Attenuate prostaglandin synthesis.	Inserted deep into the tissue. The effect occurs within 30 minutes.
Preparations having antispasmodic qualities. And later used in the late postoperative period. Relieve muscle spasm, inhibit the efficiency of prostaglandins (Ketanov, Analgin, Baralgin, Aspirin)	Apply 1-2 tablets when a severe pain.
vitamin complexes	Assigned to: improvement of collagen formation; formation of muscle tissue; increase blood clotting; normalization of hemoglobin; stabilization of erythrocyte levels.	Vitrum; Alphabet; Supradin; Duovit; Complivit.	1 tab. for 30 days.
Stimulators of the immune system Stimulators of the immune system	Shown to enhance the body's defenses, the revitalization of leukocytes	Immunal; Tincture eleuterokokka; Echinacea tincture.	30 Cap. 3-hole day. The course of treatment 1 month
anti-anxiety drugs	Stabilize the operation CNS hyperexcitability removed, improve sleep	Tincture of valerian and Leonurus	10-20 cap. 1-2 times a day.

Physiotherapy

Physiotherapy is assigned at an early stage of the process for the prevention of postoperative:

• the formation of adhesions,
• occurrence of pneumonia caused by fluid stagnation with prolonged bed rest;
• of thromboembolism;
• digestion disorders.

In the case of suppuration of postoperative seams, antibacterial therapy is conducted in conjunction with UFO and UHF:

1. UFO It is shown for rapid wound cleansing from purulent masses, and dead cells. During the procedure, electrodes are located within a radius of 5-6 cm from the wound. Showing 2-4.5 or 7-8 biodozy UV rays, depending on the condition of the patient.
2. ultrahigh frequency registers to provide anti-inflammatory and analgesic effects. Slaboteplovaya dose, treatment time of 5-10 minutes. Be no more than 5-6 procedures to avoid enhanced tissue scarring.

In order to prevent adhesions physiotherapy assigned to 3 days after the operation:

1. Electrophoresis with zinc - improves the tone and trophism of tissues in the pelvic area. An anode with a bandage soaked in 1% sulfate, zinc placed suprapubic double cathode is located below the lumbar region. The current strength of 15 mA. The duration of the procedures from 20-25 days to 20 minutes daily. Electrophoresis is shown after gynecological surgery and appendectomy.
2. Electrophoresis with hyaluronidase. It helps to improve digestion, splitting the coarse fiber foods triggers cell regeneration. The anode is installed in the lumbar region, forked cathode arranged on the abdomen. Amperage 0.5-0.8 mA / sq. cm. Duration of treatment 8-10 sessions.
3. ultrasound therapy. Carried on the front of the abdominal wall. Power US - 0.3-0.6 watt / sq. cm, length 5-6 m.

Patients who were forced for a long time to comply with bed rest, physiotherapy appointed for the prevention of pneumonia, bronchopulmonary diseases, improve the respiratory process.

They are as follows:

1. Electrophoresis heparin. Cathode with heparin patch is placed in the interscapular region. The anode is composed of two plates - on the gastrocnemius muscle. Amperage 8-10 mA / sq. cm. The duration of exposure apparatus for 10-15 minutes. The course of treatment 10-12 days.
2. short-wave therapy. Conducted at SCR-4 machine. Wave action is directed to the area of ​​the lower lobes of the lungs. Induction pipe (3 turns) is set in the thorax. For the procedure used inductance of 2 nd degree. Every day is 2-3 procedures, not exceeding Time 1 min. Therapy ranges from 8 to 10 days.
3. electrostatic vibratory and inhalation of mucolytic drugs are held to improve sputum discharge, in order to avoid stagnation of fluid in the lungs.

assigned short-wave therapy unit SCR-4 In the case of indigestion. The impact of waves is directed to a front wall of the peritoneum, for splitting the coarse fibers food. Duration - 15-20 minutes. Displaying 10-12 procedures every day or two.

Magnetic field (influence of magnetic fields on the operated zone) is recommended for all patients after lane abdominal surgery.

This fiziolechenie:

• accelerates the healing of scars;
• repairs damaged tissue cells;
• prevents adhesions;
• reduce pain.

In the operated region placed magnetic plate. It sets the device minimum power. Magnetic pulse, falling inward trigger updating process fabrics, improve blood flow, decrease the activity of prolactin. flow of the procedure from 5 minutes to an hour. The course of 8-12 days.

LFK

Exercise, appointed after the lane operations are aimed at:

• prevention of complications;
• improvement of the respiratory system, the functioning of the heart and blood vessels;
• flexible subcutaneous seam formation;
• stabilizing the psychosomatic state of the operated patient;
• the prevention of blood clots and adhesions.

Motor activity is permitted only by a physician.

Should not engage in exercise therapy if:

• the patient is suffering from cardiovascular pathologies;
• postoperative period complicated by the appearance of the heat;
• when attempting to move appears sharp pain at the wound site;
• disease complicated by peritonitis.

Postoperative motor activity is divided into:

1. Medical-physical culture to be assigned in the first days after the operation. With the surgeon's permission (from the date of termination of the anesthesia), the patient should try to sit down, do the exercises, to prevent stagnation of fluid in the lungs. The patient must sit down, sit up on the bed, to carry out a deep breath, mouth, and then exit. Releasing the air need to try to mimic the slight cough (holding hand wound). Exercises are held 5-8 min 3-hole day. 2-3-th day you need to sit up in bed, roll from side to side.
   
2. After removal of sutures (late postoperative period) exercise carried out for the development of muscles and joints. The patient must sit alone, get out of bed, slowly move around in the room and the corridor separating. Classes are held up to 4 times a day for 15 minutes.
3. After discharge, physical therapy indicated for the careful development of limbs, muscles, aching joints, preparation for normal motor activity. Fizzaryadka performed individually or in groups in the sports office (Hall) clinic or nursing home. Shows a medical walking, throwing, catching objects, exercises with fitball. Over time, the duration and intensity of exercise increases.

About 3-4 months after abdominal surgery is necessary to adhere to gentle physical mode.

It is forbidden to:

• weight lifting;
• run;
• sports training in a fitness club.

Massage

With 3-4 days after surgery carried out massage, aimed at preventing pneumonia, strengthening skeletal muscle. Masseur developing ligaments and muscles of the patient, prevents clot formation. Duration of treatment is about 20-25 minutes.

The procedure is performed by the classical method:

• Grinding begins at the upper and lower extremities;
• at the 2nd stage worked neck, neck area, the chest (if there are no wounds);
• in the final part held back massage and lumbar.

FIELD peritoneum (spot weld) is triturated.

After 1.5 months from the date of the section allowed the use of massage on the operated side, to reduce severe scarring of tissue. The use of ointments, esters helps resorbable scar, improving the blood circulation in the traumatized tissues, reduced seam volume.

diet therapy

The recovery period after abdominal surgery requires compliance with a dietary intake. The first day of the forbidden food intake. It shows only clean drinking water without aerating about 2 liters.

Over 2-3 days the patient is transferred to a zero table:

1. number 0a He appointed the first 2-3 days after surgery on the abdominal organs and intestines. Consists of water, broth hips, diluted juices and fruit drinks, strained chicken broth, unsweetened tea, perhaps the use of jelly. It is forbidden to drink milk.
   
2. Number 0B - 4-6-day operations. It includes liquid porridge, soups, pyurirovannoe boiled rabbit meat, chicken.
3. number 0 in - 6 days before transfer to another table (by disease type). It enables the use of soups, purees, milk porridge, grated cheese and sour cream, steam meatballs with pyurirovannymi vegetables.

7-8 days after the operation the patient is transferred to the table shown on the disease. You need to eat 4-5 times a day, preferably with warm food. The dishes are steamed, boiled, baked without oil.

The main objective of nutritional therapy in the postoperative period - warning bloating, diarrhea, constipation, restoration of bowel function. Diet for abdominal operations necessary to observe from 2 months up to six months.

Excluded from the daily diet:

• fried, fatty food;
• carbonated lemonade;
• confectionery factory production;
• butter, margarine;
• carcinogens and products containing the dye;
• burgers, fries, cheeseburgers;
• ice cream, chocolate, cakes, pastries;
• pickles and marinades;
• salami and sausages;
• smoked;
• canned fish and meat;
• alcoholic beverages.

Completely prohibited cigarettes.

The daily diet of protein foods should include:

• chicken, rabbit, turkey;
• cod, pollock;
• veal, lean beef;
• cheese, cheese (20% fat);
• yogurt, bioyoghurt.

As well as:

• fruits and vegetables (the resolution depending on the medical table);
• berries;
• greenery;
• fruit teas, diluted with water.

Psychotherapy

After the surgery may cause psihodepressivnogo condition caused by:

• fear of death, complications of the disease (typical for cancer patients).
• stress;
• severe pain;
• constraints arising after surgery (for removing internal organs);
• depression (most often occurs in women after amputation of the reproductive system).

After amputation of the internal organs (especially the uterus, ovaries), the patient may fear torture, based on inferiority later in life. Cancer patients, those who had undergone cardiovascular surgery afraid of death, recurrence of disease. From the first day after surgery to operate on a person needs the support of loved ones.

In the case of serious pathologies, severe internal state used psychotherapy, whose mission is:

• in arresting the development of depressive psychosis;
• in helping the patient to overcome their own internal fears;
• in removing the doubts in the patient's own inferiority caused by the conduct of operations;
• in preparation for the return of the patient to a normal life;
• help the adoption of its present state.

Psychotherapy can be carried out by a group or individually, on a personal consultation psychiatrist. To normalize the state removing somatic syndrome may be used antidepressants, anti-anxiety drugs.

Supportive linen and bandage

Recovery after abdominal surgery is not possible without the use of abdominal brace and support underwear. The bandage is a wide belt, mountable with adhesive tape.

Devices shown for:

• Retention of the internal organs in the correct position, not allowing them to go down;
• reduce the risk of postoperative hernias;
• prevent divergence seams;
• protect the wound from infection;
• restoring elasticity of skin tissue;
• reducing pain.
• aid in maintaining the mobility of the absence of constraint of movement.

Wearing a brace is necessary when:

• gastrectomy;
• removal of the uterus;
• cesarean section;
• oncologic resection of the tumor;
• of abdominal surgery on the heart.

Do not use the following devices:

• at easy operations (appendectomy);
• when a swelling of tissues in the injured area;
• bleeding at the seam.

Terms of wearing the band:

1. Supportive linen and bandage should be worn for 1-2 weeks (the time required for fusion of the joint).

   

2. In case of severe lane operations affecting a large area of ​​tissue, duration of application of the bandage is extended to 3-6 months.
3. The belt should not be worn at all times. The bandage is removed after 6-8 hours of continuous wear. Night supportive underwear is not applicable.
4. Abdominal bandage is worn in the supine position. To do this, lie on your back and relax. The belt is tightened is not very tight, man should not feel uncomfortable.

Osteopathic treatment

Osteopathy - Alternative Medicine, focused on the diagnosis and treatment of diseases by means of hands. Osteopath to treat the damaged body gently with your fingertips acting on the key points of the body without the use of additional drugs.

Osteopathy considers body in harmony, based on the body's ability to spontaneously start regeneration internal processes. Impact osteopath directed all the tissues, organs and body fluids.

The use of alternative Methodist in the postoperative period helps to:

• rapid healing seam;
• Start regeneration of cells functions;
• engage in the internal organs of its original position, the beginning of the operation in its entirety;
• Preventing adhesions and intestinal obstruction;
• elimination of stress;
• recovery of muscles, joints, recovery of motor activity.

Particular importance is attached to the connective tissue that forms a scar.

With special techniques Osteopath:

• removes tension of connective tissue in the joint area;
• relaxes the injured cavity;
• establishes circulation for faster healing and regeneration.
• eliminates intestinal obstruction.

Apply osteopathic techniques necessary to the appearance:

• severe pain;
• deterioration of general health;
• the occurrence of a depressive state;
• disorders of the digestive process;
• occurrence of pain in the lumbar region.

Refer to osteopatu follows immediately after healing of the scar. Recovery after surgery lane - a lengthy process involving a complex effect on all organs and systems of the human body. Careful adherence to medical recommendations will reduce the time to recovery more rapid return to normal life.

Registration of the article: Lozinski Oleg

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